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 | 42.22 | NA | 124,396 | 800,676 | 120,222 | ||||||||||||
| 193 | SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | Non Surgical | 41.95 | NA | 123,605 | 717,724 | 115,845 | ||||||||||||
| 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 | 15.84 | NA | 46,671 | 318,219 | 45,255 |
DEMOGRAPHIC DETAILS OF DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | Back to Top |
| Race | Total Hospitalization Volume - Jan 2017 to Dec 2017 | % of DRG Volume |
|---|---|---|
| White | 105,236 | 84.6 |
| Black | 11,051 | 8.88 |
| Hispanic | 2,550 | 2.05 |
| Age Group ( Years ) | Total Hospitalization Volume - Jan 2017 to Dec 2017 | % of DRG Volume |
|---|---|---|
| Greater than 84 | 38,616 | 31.04 |
| 80 to 84 | 19,710 | 15.84 |
| 75 to 79 | 18,302 | 14.71 |
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 2017 to Dec 2017 | % of DRG Volume |
|---|---|---|---|
| J189 | Pneumonia, unspecified organism | 86,751 | 69.74 |
| Z87891 | Personal history of nicotine dependence | 33,280 | 26.75 |
| E860 | Dehydration | 20,086 | 16.15 |
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 2017 to Dec 2017 | % of DRG Volume |
|---|---|---|---|
| 30233N1 | Transfusion of Nonautologous Red Blood Cells into Peripheral Vein, Percutaneous Approach | 2,691 | 2.16 |
| 3E03329 | Introduction of Other Anti-infective into Peripheral Vein, Percutaneous Approach | 1,633 | 1.31 |
| 02HV33Z | Insertion of Infusion Device into Superior Vena Cava, Percutaneous Approach | 1,498 | 1.2 |
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 2017 to Dec 2017 | % of DRG Volume |
|---|---|---|---|---|---|---|
| Christiana Care Wilmington Hospital | 501 W 14TH ST | Wilmington | DE | 19801 | 357 | 0.29 |
| AdventHealth Orlando | 601 E ROLLINS ST | Orlando | FL | 32803 | 327 | 0.26 |
| NorthShore University HealthSystem Evanston Hospital | 2650 RIDGE AVE | Evanston | IL | 60201 | 313 | 0.25 |
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 2017 to Dec 2017 | % of DRG Volume |
|---|---|---|---|---|---|---|
| DR. VENKATAPURAM RAMESH REDDY | 42320 HIGHWAY 195 | HALEYVILLE | AL | 35565 | 93 | 0.07 |
| DR. JOSEPH L PRATT | 121 PRATT DR | CORINTH | MS | 38834 | 40 | 0.03 |
| DR. HOUSAM I HADDAD | 187 WOLFORD AVE | LIBERTY | KY | 42539 | 36 | 0.03 |
TOP OPERATING 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 2017 to Dec 2017 | % of DRG Volume |
|---|---|---|---|---|---|---|
| DR. CLIFTON WALES SALMON | 104 MORRIS CIR | HOMER | LA | 71040 | 33 | 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 2017 to Dec 2017 | National Projected Hospitalizations(Present on Admission - Yes) Jan 2016 to Dec 2016 | Medicare Hospitalizations (Present on Admission - Yes) Jan 2017 to Dec 2017 | National Projected Hospitalizations (Present on Admission - Not Y) Jan 2016 to Dec 2016 | Medicare Hospitalizations (Present on Admission - Not Y) Jan 2017 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 | J189 | Pneumonia, unspecified organism | 229,954 | 86,751 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | I10 | Essential (primary) hypertension | 129,914 | 53,968 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | E785 | Hyperlipidemia, unspecified | 85,561 | 46,819 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | Z87891 | Personal history of nicotine dependence | 64,374 | 33,280 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | I2510 | Atherosclerotic heart disease of native coronary artery without angina pectoris | 58,114 | 32,868 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | K219 | Gastro-esophageal reflux disease without esophagitis | 54,480 | 31,482 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | E039 | Hypothyroidism, unspecified | 42,393 | 25,560 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | N179 | Acute kidney failure, unspecified | 41,480 | 23,495 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | Z7982 | Long term (current) use of aspirin | 29,915 | 22,742 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | E860 | Dehydration | 37,527 | 20,086 |