Jan 2013 to Dec 2017 | Jan 2017 to Dec 2017
CHARGE CAPTURE ANALYSIS FOR DRG 195: SIMPLE PNEUMONIA AND PLEURISY WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) 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 (%) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | ||||||||||||
| 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 |
DEMOGRAPHIC DETAILS OF DRG 195: SIMPLE PNEUMONIA AND PLEURISY WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | Back to Top |
| Race | Total Hospitalization Volume - Jan 2013 to Dec 2017 | % of DRG Volume |
|---|---|---|
| White | 276,858 | 87.0 |
| Black | 22,777 | 7.16 |
| Hispanic | 6,213 | 1.95 |
| Age Group ( Years ) | Total Hospitalization Volume - Jan 2013 to Dec 2017 | % of DRG Volume |
|---|---|---|
| Greater than 84 | 101,034 | 31.75 |
| 80 to 84 | 53,287 | 16.75 |
| 75 to 79 | 47,047 | 14.78 |
TOP ICD DIAGNOSIS CODES FOR DRG 195: SIMPLE PNEUMONIA AND PLEURISY WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | Back to Top |
| ICD Code | ICD Description | Total ICD & DRG Hospitalization Volume - Jan 2013 to Dec 2017 | % of DRG Volume |
|---|---|---|---|
| 486 | Pneumonia, organism unspecified | 180,852 | 56.83 |
| 4019 | Unspecified essential hypertension | 114,908 | 36.11 |
| J189 | Pneumonia, unspecified organism | 89,476 | 28.12 |
TOP ICD PROCEDURE CODES FOR DRG 195: SIMPLE PNEUMONIA AND PLEURISY WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | Back to Top |
| ICD Code | ICD Description | Total Procedure ICD & DRG Hospitalization Volume - Jan 2013 to Dec 2017 | % of DRG Volume |
|---|---|---|---|
| 9921 | Injection Of Antibiotic | 4,708 | 1.48 |
| 9904 | Transfusion Of Packed Cells | 3,178 | 1.0 |
| 9394 | Respiratory Medication Administered By Nebulizer | 2,699 | 0.85 |
TOP HOSPITALS ASSOCIATED WITH DRG 195: SIMPLE PNEUMONIA AND PLEURISY WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | 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 | 646 | 0.2 |
| Christiana Care Wilmington Hospital | 501 W 14TH ST | Wilmington | DE | 19801 | 590 | 0.19 |
| NorthShore University HealthSystem Evanston Hospital | 2650 RIDGE AVE | Evanston | IL | 60201 | 573 | 0.18 |
TOP ATTENDING PHYSICIAN ASSOCIATED WITH DRG 195: SIMPLE PNEUMONIA AND PLEURISY WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | 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 | 146 | 0.05 |
| DR. RICHARD J HELTON | 108 W OHIO | COALGATE | OK | 74538 | 140 | 0.04 |
| DR. TERESA J LYNN | 2011 W BROADWAY AVE | SULPHUR | OK | 73086 | 133 | 0.04 |
DRG 195: SIMPLE PNEUMONIA AND PLEURISY WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) 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 | 180,852 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | 4019 | Unspecified essential hypertension | NA | 114,908 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | J189 | Pneumonia, unspecified organism | 116,263 | 89,476 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | 2724 | Other and unspecified hyperlipidemia | NA | 69,509 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | I10 | Essential (primary) hypertension | 61,493 | 65,321 | |||||||||||||||||
| 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 | 47,809 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | 53081 | Esophageal reflux | NA | 44,938 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | 496 | Chronic airway obstruction, not elsewhere classified | NA | 44,446 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | E785 | Hyperlipidemia, unspecified | 34,688 | 39,336 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | 42731 | Atrial fibrillation | NA | 39,273 |