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 | 15.84 | NA | 46,671 | 318,219 | 45,255 | ||||||||||||
| 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 |
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 2017 to Dec 2017 | % of DRG Volume |
|---|---|---|
| White | 40,274 | 86.29 |
| Black | 3,349 | 7.18 |
| Hispanic | 962 | 2.06 |
| Age Group ( Years ) | Total Hospitalization Volume - Jan 2017 to Dec 2017 | % of DRG Volume |
|---|---|---|
| Greater than 84 | 15,668 | 33.57 |
| 80 to 84 | 7,785 | 16.68 |
| 75 to 79 | 6,898 | 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 2017 to Dec 2017 | % of DRG Volume |
|---|---|---|---|
| J189 | Pneumonia, unspecified organism | 33,521 | 71.82 |
| R0902 | Hypoxemia | 7,047 | 15.1 |
| J101 | Influenza due to other identified influenza virus with other respiratory manifestations | 3,830 | 8.21 |
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 2017 to Dec 2017 | % of DRG Volume |
|---|---|---|---|
| 3E03329 | Introduction of Other Anti-infective into Peripheral Vein, Percutaneous Approach | 670 | 1.44 |
| 3E0F7GC | Introduction of Other Therapeutic Substance into Respiratory Tract, Via Natural or Artificial Opening | 445 | 0.95 |
| 3E0234Z | Introduction of Serum, Toxoid and Vaccine into Muscle, Percutaneous Approach | 406 | 0.87 |
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 2017 to Dec 2017 | % of DRG Volume |
|---|---|---|---|---|---|---|
| NorthShore University HealthSystem Evanston Hospital | 2650 RIDGE AVE | Evanston | IL | 60201 | 126 | 0.27 |
| Christiana Care Wilmington Hospital | 501 W 14TH ST | Wilmington | DE | 19801 | 115 | 0.25 |
| Boca Raton Regional Hospital | 800 MEADOWS ROAD | Boca Raton | FL | 33486 | 114 | 0.24 |
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 2017 to Dec 2017 | % of DRG Volume |
|---|---|---|---|---|---|---|
| DR. VENKATAPURAM RAMESH REDDY | 42320 HIGHWAY 195 | HALEYVILLE | AL | 35565 | 35 | 0.07 |
| DR. TERESA J LYNN | 2011 W BROADWAY AVE | SULPHUR | OK | 73086 | 32 | 0.07 |
| DR. ROBERT WILLIAM RADER | 1000 N LEE AVE | OKLAHOMA CITY | OK | 73102 | 31 | 0.07 |
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 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 | 116,263 | 33,521 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | I10 | Essential (primary) hypertension | 61,493 | 26,305 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | E785 | Hyperlipidemia, unspecified | 34,688 | 16,489 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | K219 | Gastro-esophageal reflux disease without esophagitis | 20,905 | 10,384 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | I2510 | Atherosclerotic heart disease of native coronary artery without angina pectoris | 19,843 | 10,297 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | Z87891 | Personal history of nicotine dependence | 22,095 | 10,274 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | E039 | Hypothyroidism, unspecified | 17,471 | 8,723 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | E119 | Type 2 diabetes mellitus without complications | 20,655 | 8,488 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | Z7982 | Long term (current) use of aspirin | 11,045 | 7,953 | |||||||||||||||||
| Pulmonology | Simple Pneumonia And Pleurisy | Simple Pneumonia And Pleurisy | R0902 | Hypoxemia | 19,278 | 7,047 |