| 78096 - Generalized pain - as a primary diagnosis code | 78096 - Generalized pain - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 9.44 | |
| Readmission Rate (%) | 23.23 | |
| Unplanned Readmission Rate (%) | 18.53 | |
| Mortality Rate (%) | ||
| SNF Discharge Rate (%) | ||
| Home Discharge Rate (%) | ||
| PAYMENTS AND CHARGES | ||
| Total Medicare Payments | ||
| Payment Per Day | ||
| Payment Per Hospitalization | ||
| Total Medicare Charges | ||
| Avg. Charges | ||
| MARKET SIZING & INCIDENCE RATES | ||
| Total National Projected Hospitalizations - Annualized (Present on Admission - All) | ||
| Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - All) | ||
| Total National Projected Hospitalizations - Annualized (Present on Admission - Yes) | ||
| Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - Yes) | ||
| Total National Projected Hospitalizations - Annualized (Present on Admission - Not Y) | ||
| Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - Not Y) | ||
| Total Medicare Hospitalizations after Exclusion | ||
| DRG 948: SIGNS AND SYMPTOMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 947: SIGNS AND SYMPTOMS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|
| Total Hospitalizations at DRG | 100,276 | |
| Total Hospitalizations with ICD 78096 - Generalized pain | 392 | |
| DRG Share of Total Hospitalizations | 0.44 | |
| % of Total ICD 78096 - Generalized pain in DRG | 72.59 | |
| Avg LOS at DRG | 3.39 | |
| Avg LOS with ICD 78096 - Generalized pain | 3.27 | |
| Readmission Rate at DRG | 21.71 | |
| Readmission Rate with ICD 78096 - Generalized pain | 21.25 | |
| Unplanned Readmission Rate at DRG | 13.45 | |
| Unplanned Readmission Rate with ICD 78096 - Generalized pain | 15.53 | |
| Total Medicare payments at DRG | $466,195,388 | |
| Total Medicare payments with ICD 78096 - Generalized pain | $1,962,877 | |
| Total Medicare payment per Day at DRG | $1,371 | |
| Total Medicare payment per Day with ICD 78096 - Generalized pain | $1,532 | |
| Total Medicare payment per Hospitalization at DRG | $4,649 | |
| Total Medicare payment per Hospitalization with ICD 78096 - Generalized pain | $5,007 | |
| Total Medicare Charges at DRG | $2,100,980,417 | |
| Total Medicare Charges with ICD 78096 - Generalized pain | $8,015,359 | |
| Avg Charges at DRG | $20,952 | |
| Avg Charges with ICD 78096 - Generalized pain | $20,447 | |
| Mortality Rate at DRG | 1.0 | |
| Mortality Rate with ICD 78096 - Generalized pain | NA | |
| SNF Discharge Rate at DRG | 24.48 | |
| SNF Discharge Rate with ICD 78096 - Generalized pain | 23.47 | |
| Home Discharge Rate at DRG | 41.26 | |
| Home Discharge Rate with ICD 78096 - Generalized pain | 46.43 |
| DRG 945: REHABILITATION WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 885: PSYCHOSES | DRG 946: REHABILITATION WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 812: RED BLOOD CELL DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 602,372 | ||||
| Total Hospitalizations with ICD 78096 - Generalized pain | 3,769 | ||||
| DRG Share of Total Hospitalizations | 2.64 | ||||
| % of Total ICD 78096 - Generalized pain in DRG | 14.21 | ||||
| Avg LOS at DRG | 13.11 | ||||
| Avg LOS with ICD 78096 - Generalized pain | 13.83 | ||||
| Readmission Rate at DRG | 15.99 | ||||
| Readmission Rate with ICD 78096 - Generalized pain | 14.45 | ||||
| Unplanned Readmission Rate at DRG | 12.22 | ||||
| Unplanned Readmission Rate with ICD 78096 - Generalized pain | 10.91 | ||||
| Total Medicare payments at DRG | $11,047,686,856 | ||||
| Total Medicare payments with ICD 78096 - Generalized pain | $70,433,959 | ||||
| Total Medicare payment per Day at DRG | $1,399 | ||||
| Total Medicare payment per Day with ICD 78096 - Generalized pain | $1,351 | ||||
| Total Medicare payment per Hospitalization at DRG | $18,340 | ||||
| Total Medicare payment per Hospitalization with ICD 78096 - Generalized pain | $18,688 | ||||
| Total Medicare Charges at DRG | $25,171,736,043 | ||||
| Total Medicare Charges with ICD 78096 - Generalized pain | $161,147,892 | ||||
| Avg Charges at DRG | $41,788 | ||||
| Avg Charges with ICD 78096 - Generalized pain | $42,756 | ||||
| Mortality Rate at DRG | 0.21 | ||||
| Mortality Rate with ICD 78096 - Generalized pain | NA | ||||
| SNF Discharge Rate at DRG | 17.37 | ||||
| SNF Discharge Rate with ICD 78096 - Generalized pain | 16.79 | ||||
| Home Discharge Rate at DRG | 21.02 | ||||
| Home Discharge Rate with ICD 78096 - Generalized pain | 26.21 |
| DRG 948: SIGNS AND SYMPTOMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 057: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 641: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM , FLUIDS AND ELECTROLYTES WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 884: ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 100,276 | ||||
| Total Hospitalizations with ICD 78096 - Generalized pain | 599 | ||||
| DRG Share of Total Hospitalizations | 0.44 | ||||
| % of Total ICD 78096 - Generalized pain in DRG | 2.26 | ||||
| Avg LOS at DRG | 3.39 | ||||
| Avg LOS with ICD 78096 - Generalized pain | 3.67 | ||||
| Readmission Rate at DRG | 21.71 | ||||
| Readmission Rate with ICD 78096 - Generalized pain | 21.75 | ||||
| Unplanned Readmission Rate at DRG | 13.45 | ||||
| Unplanned Readmission Rate with ICD 78096 - Generalized pain | 15.69 | ||||
| Total Medicare payments at DRG | $466,195,388 | ||||
| Total Medicare payments with ICD 78096 - Generalized pain | $3,177,115 | ||||
| Total Medicare payment per Day at DRG | $1,371 | ||||
| Total Medicare payment per Day with ICD 78096 - Generalized pain | $1,444 | ||||
| Total Medicare payment per Hospitalization at DRG | $4,649 | ||||
| Total Medicare payment per Hospitalization with ICD 78096 - Generalized pain | $5,304 | ||||
| Total Medicare Charges at DRG | $2,100,980,417 | ||||
| Total Medicare Charges with ICD 78096 - Generalized pain | $12,726,557 | ||||
| Avg Charges at DRG | $20,952 | ||||
| Avg Charges with ICD 78096 - Generalized pain | $21,246 | ||||
| Mortality Rate at DRG | 1.0 | ||||
| Mortality Rate with ICD 78096 - Generalized pain | NA | ||||
| SNF Discharge Rate at DRG | 24.48 | ||||
| SNF Discharge Rate with ICD 78096 - Generalized pain | 25.38 | ||||
| Home Discharge Rate at DRG | 41.26 | ||||
| Home Discharge Rate with ICD 78096 - Generalized pain | 40.73 |
| DRG 897: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 123,354 | ||||
| Total Hospitalizations with ICD 78096 - Generalized pain | 360 | ||||
| DRG Share of Total Hospitalizations | 0.54 | ||||
| % of Total ICD 78096 - Generalized pain in DRG | 1.36 | ||||
| Avg LOS at DRG | 5.68 | ||||
| Avg LOS with ICD 78096 - Generalized pain | 6.97 | ||||
| Readmission Rate at DRG | 27.97 | ||||
| Readmission Rate with ICD 78096 - Generalized pain | 25.22 | ||||
| Unplanned Readmission Rate at DRG | 12.96 | ||||
| Unplanned Readmission Rate with ICD 78096 - Generalized pain | 10.72 | ||||
| Total Medicare payments at DRG | $587,825,453 | ||||
| Total Medicare payments with ICD 78096 - Generalized pain | $1,862,698 | ||||
| Total Medicare payment per Day at DRG | $839 | ||||
| Total Medicare payment per Day with ICD 78096 - Generalized pain | $743 | ||||
| Total Medicare payment per Hospitalization at DRG | $4,765 | ||||
| Total Medicare payment per Hospitalization with ICD 78096 - Generalized pain | $5,174 | ||||
| Total Medicare Charges at DRG | $2,077,306,032 | ||||
| Total Medicare Charges with ICD 78096 - Generalized pain | $5,586,751 | ||||
| Avg Charges at DRG | $16,840 | ||||
| Avg Charges with ICD 78096 - Generalized pain | $15,519 | ||||
| Mortality Rate at DRG | 0.03 | ||||
| Mortality Rate with ICD 78096 - Generalized pain | NA | ||||
| SNF Discharge Rate at DRG | 5.97 | ||||
| SNF Discharge Rate with ICD 78096 - Generalized pain | 3.33 | ||||
| Home Discharge Rate at DRG | 79.7 | ||||
| Home Discharge Rate with ICD 78096 - Generalized pain | 85.0 |
| DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 603: CELLULITIS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 274,950 | ||||
| Total Hospitalizations with ICD 78096 - Generalized pain | 251 | ||||
| DRG Share of Total Hospitalizations | 1.2 | ||||
| % of Total ICD 78096 - Generalized pain in DRG | 0.95 | ||||
| Avg LOS at DRG | 6.96 | ||||
| Avg LOS with ICD 78096 - Generalized pain | 9.95 | ||||
| Readmission Rate at DRG | 27.13 | ||||
| Readmission Rate with ICD 78096 - Generalized pain | 28.43 | ||||
| Unplanned Readmission Rate at DRG | 20.24 | ||||
| Unplanned Readmission Rate with ICD 78096 - Generalized pain | 18.27 | ||||
| Total Medicare payments at DRG | $2,790,739,849 | ||||
| Total Medicare payments with ICD 78096 - Generalized pain | $3,687,482 | ||||
| Total Medicare payment per Day at DRG | $1,457 | ||||
| Total Medicare payment per Day with ICD 78096 - Generalized pain | $1,477 | ||||
| Total Medicare payment per Hospitalization at DRG | $10,150 | ||||
| Total Medicare payment per Hospitalization with ICD 78096 - Generalized pain | $14,691 | ||||
| Total Medicare Charges at DRG | $11,867,056,741 | ||||
| Total Medicare Charges with ICD 78096 - Generalized pain | $14,175,952 | ||||
| Avg Charges at DRG | $43,161 | ||||
| Avg Charges with ICD 78096 - Generalized pain | $56,478 | ||||
| Mortality Rate at DRG | 7.44 | ||||
| Mortality Rate with ICD 78096 - Generalized pain | 15.54 | ||||
| SNF Discharge Rate at DRG | 20.22 | ||||
| SNF Discharge Rate with ICD 78096 - Generalized pain | 21.51 | ||||
| Home Discharge Rate at DRG | 37.4 | ||||
| Home Discharge Rate with ICD 78096 - Generalized pain | 25.5 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| CALVARY HOSPITAL | 1740 EASTCHESTER RD | BRONX | NY | 10461 | 790 |
| LANCASTER REHABILITATION HOSPITAL | 675 GOOD DRIVE | LANCASTER | PA | 17601 | 497 |
| BROOKS REHABILITATION HOSPITAL | 3599 UNIVERSITY BLVD S | JACKSONVILLE | FL | 32216 | 391 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| Dr. JOSE A MATUS | 321 N HIGHLAND AVE | SHERMAN | TX | 75092 | 85 |
| Dr. DEVMANI JAITLY | 1740 EASTCHESTER ROAD | BRONX | NY | 10461 | 49 |
| Dr. SREENIVASA R PATIBANDLA | 1740 EASTCHESTER RD | BRONX | NY | 10461 | 47 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| Dr. DEAN M GODFREY | 1603 W MCGALLIARD AVE | TRENTON | NJ | 08610 | 325 |
| Dr. JOSE A MATUS | 321 N HIGHLAND AVE | SHERMAN | TX | 75092 | 243 |
| Dr. FAN XI | 2800 ASHTON DRIVE | WILMINGTON | NC | 28412 | 207 |