Jan 2013 to Dec 2017   |   Jan 2017 to Dec 2017
CHARGE CAPTURE ANALYSIS FOR DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) GROUP BASED ON MEDICARE | Back to Top |
DRG Code | DRG Description | Category | Sub Category | DRG Group | Surgical Category | Case Mix Level | Total National Projected Hospitalizations - Annualized | Total Medicare Hospitalizations - Jan 2017 to Dec 2017 | Total Medicare Hospitalizations - Jan 2013 to Dec 2017 | Total Medicare Hospitalizations After Exclusion | Avg. LOS | GMLOS | All Cause Readmission Rate (%) | Unplanned Readmission Rate (%) | Total Medicare Payments | Payment per Day | Payment per Discharge | Total Medicare Charges | Avg. Charges | Mortality Rate (%) | SNF Discharge Rate (%) | Home Discharge Rate (%) |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
194 | SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | Non Surgical | 43.60 | NA | 124,396 | 800,676 | 771,083 | ||||||||||||
193 | SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | Non Surgical | 39.08 | NA | 123,605 | 717,724 | 664,932 | ||||||||||||
195 | SIMPLE PNEUMONIA AND PLEURISY WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | Non Surgical | 17.33 | NA | 46,671 | 318,219 | 307,566 |
DEMOGRAPHIC DETAILS OF DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | Back to Top |
Race | Total Hospitalization Volume - Jan 2013 to Dec 2017 | % of DRG Volume |
---|---|---|
White | 685,713 | 85.64 |
Black | 68,646 | 8.57 |
Hispanic | 15,909 | 1.99 |
Age Group ( Years ) | Total Hospitalization Volume - Jan 2013 to Dec 2017 | % of DRG Volume |
---|---|---|
Greater than 84 | 236,491 | 29.54 |
80 to 84 | 128,139 | 16.0 |
75 to 79 | 117,938 | 14.73 |
TOP ICD DIAGNOSIS CODES FOR DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | Back to Top |
ICD Code | ICD Description | Total ICD & DRG Hospitalization Volume - Jan 2013 to Dec 2017 | % of DRG Volume |
---|---|---|---|
486 | Pneumonia, organism unspecified | 433,088 | 54.09 |
4019 | Unspecified essential hypertension | 242,172 | 30.25 |
J189 | Pneumonia, unspecified organism | 237,122 | 29.62 |
TOP ICD PROCEDURE CODES FOR DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | Back to Top |
ICD Code | ICD Description | Total Procedure ICD & DRG Hospitalization Volume - Jan 2013 to Dec 2017 | % of DRG Volume |
---|---|---|---|
9904 | Transfusion Of Packed Cells | 21,454 | 2.68 |
3491 | Thoracentesis | 11,394 | 1.42 |
9921 | Injection Of Antibiotic | 10,944 | 1.37 |
TOP HOSPITALS ASSOCIATED WITH DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | Back to Top |
Hospital Name | Address | City | State | Zip Code | Total Hospital & DRG Hospitalization Volume - Jan 2013 to Dec 2017 | % of DRG Volume |
---|---|---|---|---|---|---|
AdventHealth Orlando | 601 E ROLLINS ST | Orlando | FL | 32803 | 1,950 | 0.24 |
Christiana Care Wilmington Hospital | 501 W 14TH ST | Wilmington | DE | 19801 | 1,834 | 0.23 |
University of Texas MD Anderson Cancer Center | 1515 HOLCOMBE BLVD | Houston | TX | 77030 | 1,388 | 0.17 |
TOP ATTENDING PHYSICIAN ASSOCIATED WITH DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | Back to Top |
Physician Name | Address | City | State | Zip Code | Total Physician & DRG Hospitalization Volume - Jan 2013 to Dec 2017 | % of DRG Volume |
---|---|---|---|---|---|---|
DR. VENKATAPURAM RAMESH REDDY | 42320 HIGHWAY 195 | HALEYVILLE | AL | 35565 | 779 | 0.1 |
DR. HOUSAM I HADDAD | 187 WOLFORD AVE | LIBERTY | KY | 42539 | 234 | 0.03 |
DR. STANLEY K MORROW | 34867 HWY 43 | HACKLEBURG | AL | 35564 | 229 | 0.03 |
DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) SUMMARY TABLE | Back to Top |
Category | Sub Category | DRG Group | ICD Codes | ICD Description | National Projected Hospitalizations (Present on Admission - All) Jan 2016 to Dec 2016 | Medicare Hospitalizations (Present on Admission - All) Jan 2013 to Dec 2017 | National Projected Hospitalizations(Present on Admission - Yes) Jan 2016 to Dec 2016 | Medicare Hospitalizations (Present on Admission - Yes) Jan 2013 to Dec 2017 | National Projected Hospitalizations (Present on Admission - Not Y) Jan 2016 to Dec 2016 | Medicare Hospitalizations (Present on Admission - Not Y) Jan 2013 to Dec 2017 | Total Discharges After Exclusion | Avg. LOS | GMLOS | All Cause Readmission Rate (%) | Unplanned Readmission Rate (%) | Total Medicare Payments | Payment per Day | Payment per Discharge | Total Medicare Charges | Avg. Charges | Mortality Rate (%) | SNF Discharge Rate (%) | Home Discharge Rate (%) |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | 486 | Pneumonia, organism unspecified | NA | 433,088 | |||||||||||||||||
Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | 4019 | Unspecified essential hypertension | NA | 242,172 | |||||||||||||||||
Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | J189 | Pneumonia, unspecified organism | 229,954 | 237,122 | |||||||||||||||||
Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | 2724 | Other and unspecified hyperlipidemia | NA | 173,208 | |||||||||||||||||
Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | I10 | Essential (primary) hypertension | 129,914 | 147,825 | |||||||||||||||||
Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | 4280 | Congestive heart failure, unspecified | NA | 119,176 | |||||||||||||||||
Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | 53081 | Esophageal reflux | NA | 117,410 | |||||||||||||||||
Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | 42731 | Atrial fibrillation | NA | 117,269 | |||||||||||||||||
Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | 25000 | Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled | NA | 116,728 | |||||||||||||||||
Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | E785 | Hyperlipidemia, unspecified | 85,561 | 113,546 |