Appendix Table 1.
How Coding of Hospital-acquired Complications Impacts Hospital Payment and Public Reporting
| Coding Scenario |
Secondary diagnosis ICD-9-CMs listed in discharge claims data, in addition to principal diagnosis 481 “pneumococcal pneumonia” |
Status of diagnosis at admission (as coded with POA indicator variable) |
Hospital Paymenta |
Would a hospital-acquired complication be publicly reported from this record? |
|---|---|---|---|---|
| A | No secondary diagnoses listed | Not Applicable | $6365 | No |
| B | Urinary tract infection (599.0) | Hospital-acquired | $8749 | No |
| C | Urinary tract infection (599.0) | Present-on-Admission | $8749 | No |
| D | Urinary tract infection (599.0) | Hospital-Acquired | $6365 | Yes |
| Infection and inflammatory reaction due to indwelling urinary catheter (996.64) |
Hospital-Acquired | |||
| E | Urinary tract infection (599.0) | Hospital-Acquired | $8749 | Yes |
| Infection and inflammatory reaction due to indwelling urinary catheter (996.64) |
Hospital-Acquired | |||
| Systolic Heart failure (428.22) | Present-on-Admission |
a
Payments are calculated assuming base rate of $8700, the base rate for admissions with a cost weight of 1.0 to the University of Michigan in 2009.