V37 Manual

The link to our v37 technical documentation is here: [link]

Which Executables Work With Which Masks Files?

QUESTION:
Which Executables Work With Which Masks Files?

ANSWER:
Our code base is effectively split into the original branch which supports ICD9cm codes and the new branch which supports ICD10 codes.

The original branch has version numbers which begin with f (for "federal") while the new branch has version numbers which start with v. The original branch starts with f2 and ends with f32. The new branch starts with v33 and is currently up to v36.

In order to assign a DRG, you need both the logic (which we encode in the software) and the attributes or "masks" (which we encode in masks files).

The original branch is backwardly compatible: f32 has all the logic for some early version (f6, I believe) up and including f32. (The versions are internally designated with letters, so each executable can only support 26 versions. We have an executable and masks which support f2-f5 but that combination is a special order item).

The new branch is not backwardly compatible: v33 only supports v33, v34 only supports v34, etc. So v36 cannot use v34 masks because it does not have v34 logic in it.

We have a project on the books to combine all the logic into a backwardly compatible super-set, but currently this project is inactive.

Discharge Disposition

Discharge disposition has, alas, been coded by at least two different standards: UB82 and UHDDS. We try to support both but it has been years since we say UHDDS codes so we are not sure how much longer we will support them.

Here is the mapping we usually use:

    "0 - Unknown"
    "1 - Home"
    "2 - Other Hosp"
    "3 - SNF"
    "4 - ICF"
    "5 - Other Inst"
    "6 - Home Care"
    "7 - AMA"
    "20- Expired"

As bit-bashers, we are happy with this rather simple listing. If you want to know more, check out these links:

https://www.cms.gov/Medicare/Medicare-Contracting/ContractorLearningResources/downloads/JA0801.pdf

https://www.resdac.org/cms-data/variables/patient-discharge-status-code

V36 Validation

Looks like 460 cases fail, with 57 underlying DRGs. That should not be too bad.

Update Sun Sep 30 7:11pm Eastern: we are close, but not close enough to pull the trigger tonight. We are expecting to finish validation and do the release by the end of business tomorrow.

Update Mon Oct 1 7:04pm Eastern: we are down to two DRG definitions which have issues; we ran into issues interpreting the specs for some of the pseudo-code, requiring us to slog through the IBM 360 assembler version. But we are now very confident that we will finish validation early tomorrow and do the release tomorrow afternoon.

Update Tue Oct 2 11:22am Eastern: the official test data set passes through our DRG engine without any issues, so QA is done and we are starting the release process.

Update Wed Oct 3 2:11pm Eastern: our usual 32 bit Linux environment is out of action and we have to move to the backup environment which is taking some time. It is not clear how many more 32 bit Linux releases we will do.

Update Wed Oct 3 8:34pm Eastern: our back up 32 bit Linux environment has been configured and our development system ported to it and now we have 32 bit Linux executables again.

V36 Masks & Weights

The V36 masks and weights file has been built and validated. The logic module is still under construction. This year's differences from last year are pretty massive. Validation is going to be epic this year.

V36 Begins

We have downloaded the latest files from CMS and have begun the development process. Sadly for us, the logic file has been formatted in such a way as to make discerning differences from the previous version rather painful, but as soon as we have a sense of what we are dealing with, we will update this blog with an expected release date.

Backward Compatibility in ICD10 Versions

QUESTION:

Hello, we have used your grouper for several years now, but v35 is the first one that hasn't seemed to be backward compatible to old masks. It groups fine under 35, but if we try to use the 34 mask with the cdrgv35a binary it doesn't return anything. Is this a known issue or something others have dealt with?

ANSWER:

Alas, this is a feature: starting with v32 (our first ICD10-based production release), we gave up backward compatibility for the logic component.

(Note that versions which begin with 'f' are ICD9-based while those that begin with 'v' are ICD10-based. Those that begin with 'x' are experimental.)

The CMS release process changed dramatically, so our release process had to change dramatically as well. In order to assign v34 DRGs you will need the v34 DLL.