Executive Summary
On March 30th, 2018 we re-released v35 as v35a to fix a couple of issues. We are sending our free uploads to all the customers who purchased v35 products.
1. The descriptions of ten DRGs (out of the 754) were truncated in the DRG masks file which was part of our initial v35 release;
2. The mean attribute of 73 DRGs were wrong due to a difference in the CMS input files;
3. The mean attribute was not handled correctly by our helper app interface, which affected DLLs, libraries and shared objects (but NOT DRGFilt);
This issues did not impair the ability of our software to assign version35 DRGs, or the weights returned for any DRG assigned. But ten of the descriptions were truncated and 73 of the means were wrong in the reference file and some of the software mishandled the number decimal places in the Geometric Mean Length of Stay (GMLOS).
So DRGFilt customers need only use the new drgmasks.v35 file that comes with the v35a release.
Here is how to know if you have the right masks file: we use the MD 5 Sum:
(
https://en.wikipedia.org/wiki/Md5sum)
9117f5ff47cc11df5ef4dfc7c195c30f v35/drgmasks.v35
7ce8af1b3a9aa50f605de3f2dabe4ae3 v35a/drgmasks.v35
Details
A client reported that a DRG description was wrong, which we quickly confirmed. Confirming the problem led us to review our mask file creation process and to build a new validation process. We found that the input file from CMS had changed slightly and caused two problems:
1. The DRG description lengths were sometimes much longer than they used to be, so our current maximum of 72 characters was too short for these DRGs: 23, 61, 62, 246, 248, 469, 470, 829, 830
2. The DRG means were imported with the wrong number of implied decimal places for means which were whole numbers, 4.0 became 0.4.
3. For the interface to the DLL, shared objects and libraries, someone fixed the decimal point handling for the part of system, which is why the masks file passed the old validation process.
Going forward we expect the new validation process to catch any future issues with the masks files.
As for the descriptions, we had two choices: (a) to try to edit the descriptions to fit in the current space or (b) to expand the length of the DRG description field in the masks file.
For this year, we decided to go for option (a) to minimize disruption with our software and with our customer's software. The choices we made, which we ran by an outside Medical Records expert before releasing, are listed below.
But as we underestimated the difficulty with shortening the descriptions so starting next year we expect to simply size the DRG description field to accomodate the longest DRG description for any given version.
The descriptions are given below: first the CMS long description and our modified, shortened version.
DRG 023
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CRANIOTOMY W MAJOR DEVICE IMPLANT OR ACUTE CNS PDX W MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY W NEUROSTIMULATOR
CRANIOTOMY W MAJOR DEVICE IMPLANT OR ACUTE CNS PDX W MCC OR CHEMOTHERAPY
DRG 061
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ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGENT W MCC
ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLY
DRG 062
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ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGENT W CC
ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLY
DRG 246
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PERCUTANEOUS CARDIOVASCULAR PROCEDURES W DRUG-ELUTING STENT W MCC OR 4+ ARTERIES OR STENTS
PERCUTANEOUS CARDIOVASCULAR PROCEDURES W DRUG-ELUTING STENT W MCC OR 4+
DRG 248
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PERCUTANEOUS CARDIOVASCULAR PROCEDURES W NON-DRUG-ELUTING STENT W MCC OR 4+ ARTERIES OR STENTS
PERCUTANEOUS CARDIOVASCULAR PROCEDURES W NON-DRUG-ELUTING STENT W MCC OR
DRG 469
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MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC OR TOTAL ANKLE REPLACEMENT
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY
DRG 470
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MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY
DRG 829
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MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS W OTHER PROCEDURE W CC/MCC
MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS W OTHER
DRG 830
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MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS W OTHER PROCEDURE W/O CC/MCC
MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS W OTHER
