Emergency Room Diagnosis

The diagnosis categories used in the Emergency Room MICA are based on the principal diagnosis which is submitted as the first of 23 possible diagnoses coded on the emergency room visit record.

For data after the fourth quarter of 2015, diagnoses and procedures associated with hospitalizations are classified in accordance with the Tenth Revision of the International Classification of Diseases, Clinical Modification (ICD-10-CM). This classification is the result of close collaboration among many nations and non-governmental organizations, under the auspices of the World Health Organization. Its original use was to classify causes of mortality. Later, it was extended to include diagnoses in morbidity. For example, the "clinical modification" of the ICD is used in categorizing hospital diagnoses. In practice, the ICD has become the international standard diagnostic classification for all general epidemiological, as well as health management, purposes. The tenth revision of the ICD has been used to classify disease and procedures beginning in the first quarter of 2016, through current day.

Clinical Classification Software Refined

The procedure and diagnostic groupings used in the hospitalization Profiles and MICA are based on the Clinical Classification Software Refined (CCSR). CCSR is a tool for clustering patient diagnoses and procedures into a manageable number of clinically meaningful categories. It was developed by the Agency for Healthcare Research and Quality (AHRQ - formerly known as the Agency for Health Care Policy and Research (AHCPR)). The tool is updated periodically. The CCSR compresses the 70,000 diagnosis codes of the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) into 500 mutually exclusive categories. In its multi-level mode, the system further categorizes these 500 categories into some 60 intermediate level groupings. Those 60 groupings are further condensed into the 19 primary classification categories. The system can be used with any data that are coded using the ICD-10-CM. It has been shown to be helpful in understanding and analyzing patient data by managed care plans, insurers and researchers.

Further information on the clinical classification, as well as the list of diagnoses and procedures utilized by CCS, can be found at https://hcup-us.ahrq.gov/toolssoftware/ccsr/ccs_refined.jsp.