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HCUP Methods Series Comorbidity Software Documentation
Report #2004-1
 
HCUP Methods Series Comorbidity Software Documentation
 
Report #2004-1
 
Contact Information:


Healthcare Cost and Utilization Project (HCUP)
Agency for Healthcare Research and Quality
http://www.hcup-us.ahrq.gov


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Email: hcup@ahrq.gov

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Recommended Citation: Elixhauser A, Steiner C, Kruzikas D.Comorbidity Software Documentation, January 2004. HCUP Method Series Report # 2004-01. ONLINE February 6, 2004. U.S. Agency for Healthcare Research and Quality.
Available: http://www.hcup-us.ahrq.gov/toolssoftware/comorbidity/comorbidity.jsp
 
 
 
Table of Contents
 
 
Summary

Comorbidity Software Appendix 1

Appendix 2
 
Summary

The Comorbidity Software is a tool that assigns variables to identify comorbidities in hospital discharge records using diagnosis coding from the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM). This software, consisting of two computer programs, was developed at the Agency for Healthcare Research and Quality (AHRQ, formerly known as the Agency for Health Care Policy and Research).

This document describes the software that maps ICD-9-CM diagnosis codes into comorbidity indicators, as reported by Elixhauser et al. (Comorbidity Measures for Use with Administrative Data. Medical Care, 1998;36:8-27). The report includes the technical documentation for the Comorbidity Software and describes three topics:

  • Data elements required for the programs.
  • The SAS programs.
  • How to use the SAS programs on an IBM-compatible PC.
The first software download is the format program that defines a format library needed to complete comorbidity analysis. The second download program is the analysis program that assigns an indicator to each inpatient record for the comorbidity variables of interest.

These programs will be useful to researchers and policy analysts seeking information on ways to assess and control for disease severity.
 
 
Comorbidity Software


Comorbidity software assigns variables that identify comorbidities in hospital discharge records using the diagnosis coding of ICD-9-CM (International Classification of Diseases, Ninth Edition, Clinical Modifications). This document describes the software that creates the comorbidity measures reported by Elixhauser et al. ("Comorbidity Measures for Use with Administrative Data." Medical Care, 1998;36:8-27).

The comorbidity software consists of two SAS computer programs for PCs. Although these programs are written in SAS, they are being distributed in ASCII so that they can be readily adapted to other programming languages.

The first program, Creation of Format Library for Comorbidity Groups, creates a SAS format library that maps diagnosis codes into comorbidity indicators. Additional formats are created to exclude conditions that may be complications or that may be related to the principal diagnosis.

The second SAS program, Creation of Comorbidity Variables, applies these formats to a data set containing administrative data.

This document describes three topics:
  • Data elements required for the programs.
  • The SAS programs.
  • How to use the SAS programs on an IBM-compatible PC.
 
Data Elements and Coding Conventions

The input data file must contain certain elements that are coded in specific ways. These elements are required for the assignment of the comorbidity flags. The flags are 0/1 indicators that note whether individual records include each comorbidity.

The input data set must have the following two variables:
  • Diagnosis-related groups (DRGs).
  • Diagnostic codes (ICD-9-CMs).
The required elements and coding are detailed further below.


Required Elements of Input File

Element Type Length Label and Uniform Coding
DRG Num 3 DRG in effect on discharge date, assigned by the DRG Grouper algorithm of the Health Care Financing Administration (HCFA)
DX1 Char 5 Principal diagnosis, annnn (blanks indicate missing)
DX2-DXn Char 5 Secondary diagnoses 2-n, where n varies by data set
NDX Num 3 Number of diagnoses on this discharge. (Note: A macro variable defines this element; it is currently set as 2.) NDX should always be equal or less than the macro variable called NUMDX.
 
 
Format Program
Creation of Format Library for Comorbidity Groups


The format program defines a format library that contains the diagnosis screens necessary for the comorbidity analysis. It will be used by Program 2, the comorbidity analysis program.

  • Input: None
  • Output: Permanent SAS format library called \FMTLIB\formats.sc2.
  • Changes: The code points to a directory called FMTLIB on the c: drive for the format library output file. If you use another directory or drive, this code must be changed. Initially, this directory should be defined.
 
Analysis Program
Creation of Comorbidity Variables


The analysis program assigns to the inpatient records 0/1 indicators for the comorbidity variables of interest. This program assumes that the input data file conforms to specific variables names, attributes, and coding conventions, as described above.

  • Input: SAS inpatient data (CORE) conforming to HCUP coding conventions (described above), and SAS format library (FMTLIB), created from the included format program.
  • Output: SAS data set (ANALYSIS) containing inpatient records with their comorbidity indicators. The contents of the ANALYSIS file and the means for the comorbidity variables are output as hard copy. The output file is called ANALYSIS; if your file name differs, the DATA statement needs to be changed.
  • Changes: The code points to a directory called DATA on the c: drive for the input and output files. If you use another directory or drive, this code must be changed. Initially, the DATA directory needs to be defined. The macro variable (NUMDX) that defines the number of diagnoses on your data file needs to be defined (change the "2" to the appropriate number).
The macro variable (CORE) that defines the input file (SASname) needs to be defined; change the XXXXXX to the appropriate name.

There is an options statement that defines page and line size preferences; the settings currently are linesize=159 and pagesize=56. These settings can be changed, depending upon whether you prefer portrait or landscape style output.
 
 
Diagnoses and DRG´s
ICD-9-CM and DRG coding changes through September 30, 2004, are incorporated into this software. Appendix 1 contains these coding changes.
 
 
Variables Created
Thirty comorbidity variables are created using the comorbidity software, based on the format library. The library contains formats for the ICD-9-CM codes and DRG screens. Construction of these variables is summarized in Appendix 2.

The original table appeared in the paper by Elixhauser et al (1998). This table has been updated to reflect the ICD-9-CM and DRG updates in the software.
 
 
Software Download
The comorbidity program files can be downloaded from the HCUP-US website at:

http://www.hcup-us.ahrq.gov/toolssoftware/comorbidity/comorbidity.jsp#download

Though they are written in SAS, both files are being distributed in ASCII so they can be readily adapted to other programming languages.
 
 
Appendix 1. Changes Made to Comorbidity Software for FY2004, Version 2.0
The following changes were made to the Comorbidity Software for fiscal year 2004. This year included not only ICD-9-CM updates for fiscal year 2004, but also some modifications to the software as described below. These changes are incorporated in the tool currently available: Comorbidity Software, Version 2.0.
3313
ICD-9-CM Changes to the Comorbidity Software, FY2004
ICD-9-CM Diagnosis Code ICD-9-CM Diagnosis Code Label Comorbidity Assignment
07022 HPT B CHRN COMA WO DLTA Liver Disease
07023 HPT B CHRN COMA W DLTA Liver Disease
07044 CHRNC HPT C W HEPAT COMA Liver Disease
25080 DMII OTH NT ST UNCNTRLD Diabetes with chronic complications
25081 DMI OTH NT ST UNCNTRLD Diabetes with chronic complications
25082 DMII OTH UNCNTRLD Diabetes with chronic complications
25083 DMI OTH UNCNTRLD Diabetes with chronic complications
28521 ANEMIA IN ESRD Deficiency anemias
28522 ANEMIA IN NEOPLASTIC DIS Deficiency anemias
28529 ANEMIA-OTH CHRONIC ILL Deficiency anemias
28981* PRIM HYPERCOAGULABLE ST Coagulopathy - note: this comorbidity
should be dropped when used with the AHRQ
Patient Safety Indicators
28982* SEC HYPERCOGABULABLE ST Coagulopathy - note: this comorbidity
should be dropped when used with the AHRQ
Patient Safety Indicators
2910 DELIRIUM TREMENS Alcohol abuse
2913 ALCOHOLIC HALLUCINOSIS Alcohol abuse
3300 LEUKODYSTROPHY Other neurological
3301 CEREBRAL LIPIDOSES Other neurological
3302 CEREB DEGEN IN LIPIDOSIS Other neurological
3303 CERB DEG CHLD IN OTH DIS Other neurological
3308 DEREB DEGEN IN CHILD NEC Other neurological
3309 CEREB DEGEN IN CHILD NOS Other neurological
3310 ALZHEIMER’S DISEASE Other neurological
33111* PICK’S DISEASE Other neurological
33119* FRONTOTEMP DEMENTIA NEC Other neurological
3312 SENILE DEGENERAT BRAIN Other neurological
COMMUNICAT HYDROCEPHALUS Other neurological
3314 OBSTRUCTIV HYDROCEPHALUS Other neurological
3317 CEREB DEGEN IN OTH DIS Other neurological
33181 REYE’S SYNDROME Other neurological
33182* DEMENTIA W LEWY BODIES Other neurological
33189 CEREB DEGENERATION NEC Other neurological
3452 PETIT MAL STATUS Other neurological
3453 GRAND MAL STATUS Other neurological
34560 INF SPASM W/O INTR EPIL Other neurological
34561 INF SPASM W INTRACT EPIL Other neurological
34570 EPIL PAR CONT W/O INT EP Other neurological
34571 EPIL PAR CONT W INTR EPI Other neurological
34830* ENCEPHALOPATHY NOS Other neurological
34831* METABOLIC ENCEPHALOPATHY Other neurological
34839* ENCEPHALOPATHY NEC Other neurological
4010 MALIGNANT HYPERTENSION Hypertension, complicated
40200 MAL HYP HT DIS W/O HF Hypertension, complicated
40201 MAL HYPERT HRT DIS W HF Congestive heart failure (CHF)
40300 MAL HYP REN W/O REN FAIL Hypertension, complicated
40301 MAL HYP REN W RENAL FAIL Renal failure
40310 BEN HYP REN W/O REN FAIL Hypertension, complicated
40390 HYP REN NOS W/O REN FAIL Hypertension, complicated
40400 MAL HY HT/REN W/O HF/RF Hypertension, complicated
40401 MAL HYPER HRT/REN W HF Congestive heart failure (CHF)
40402 MAL HY HT/REN W REN FAIL Renal failure
40403 MAL HYP HRT/REN W HF&RF Renal failure
40410 BEN HY HT/REN W/O HF/RF Hypertension, complicated
40413 BEN HYP HRT/REN W HF&RF Renal failure
40493 HYP HRT/REN NOS W HF&RF Renal failure
40501 MAL RENOVASC HYPERTENS Hypertension, complicated
40509 MAL SECOND HYPERTEN NEC Hypertension, complicated
43820 LATE EF-HEMPLGA SIDE NOS Paralysis
43821 LATE EF-HEMPLGA DOM SIDE Paralysis
43822 LATE EF-HEMIPLGA NON-DOM Paralysis
43830 LATE EF-MPLGA UP LMB NOS Paralysis
43831 LATE EF-MPLGA UP LMB DOM Paralysis
43832 LT EF-MPLGA UPLMB NONDOM Paralysis
43840 LTE EF-MPLGA LOW LMB NOS Paralysis
43841 LTE EF-MPLGA LOW LMB DOM Paralysis
43842 LT EF-MPLGA LOWLMB NONDM Paralysis
43850 LT EF OTH PARAL SIDE NOS Paralysis
43851 LT EF OTH PARAL DOM SIDE Paralysis
43852 LT EF OTH PARALS NON-DOM Paralysis
43853 LT EF OTH PARALS-BILAT Paralysis
44100 DSCT OF AORTA UNSP SITE Peripheral vascular disorder
44101 DSCT OF THORACIC AORTA Peripheral vascular disorder
44102 DSCT OF ABDOMINAL AORTA Peripheral vascular disorder
44103 DSCT OF THORACOABD AORTA Peripheral vascular disorder
4411 RUPTUR THORACIC ANEURYSM Peripheral vascular disorder
4413 RUPT ABD AORTIC ANEURYSM Peripheral vascular disorder
4415 RUPT AORTIC ANEURYSM NOS Peripheral vascular disorder
4416 THORACOABD ANEURYSM RUPT Peripheral vascular disorder
4420 UPPER EXTREMITY ANEURYSM Peripheral vascular disorder
4421 RENAL ARTERY ANEURYSM Peripheral vascular disorder
4422 ILIAC ARTERY ANEURYSM Peripheral vascular disorder
4423 LOWER EXTREMITY ANEURYSM Peripheral vascular disorder
44281 ANEURYSM OF NECK Peripheral vascular disorder
44282 SUBCLAVIAN ANEURYSM Peripheral vascular disorder
44283 SPLENIC ARTERY ANEURYSM Peripheral vascular disorder
44284 VISCERAL ANEURYSM NEC Peripheral vascular disorder
44289 ANEURYSM NEC Peripheral vascular disorder
4429 ANEURYSM NOS Peripheral vascular disorder
49381* EXERCSE IND BRONCHOSPASM Chronic pulmonary disease
49382* COUGH VARIANT ASHTMA Chronic pulmonary disease
49392 ASTHMA NOS W (AC) EXAC Chronic pulmonary disease
53141 CHR STOM ULC W HEM-OBSTR Peptic ulcer disease including bleeding
53151 CHR STOM ULC W PERF-OBST Peptic ulcer disease including bleeding
53161 CHRSTOM ULC HEM-PERF-OB Peptic ulcer disease including bleeding
53171 CHR STOMACH ULC NOS-OBST Peptic ulcer disease including bleeding
53191 STOMACH ULCER NOS-OBSTR Peptic ulcer disease including bleeding
53241 CHR DUODEN ULC HEM-OBSTR Peptic ulcer disease including bleeding
53251 CHR DUODEN ULC PERF-OBST Peptic ulcer disease including bleeding
53261 CHR DUOD ULC HEM/PERF-OB Peptic ulcer disease including bleeding
53271 CHR DUODEN ULC NOS-OBSTR Peptic ulcer disease including bleeding
53291 DUODENAL ULCER NOS-OBSTR Peptic ulcer disease including bleeding
53341 CHR PEPTIC ULC W HEM-OBS Peptic ulcer disease including bleeding
53351 CHR PEPTIC ULC PERF-OBST Peptic ulcer disease including bleeding
53361 CHR PEPT ULC HEM/PERF-OB Peptic ulcer disease including bleeding
53371 CHR PEPTIC ULCER NOS-OBS Peptic ulcer disease including bleeding
53391 PEPTIC ULCER NOS-OBSTRUC Peptic ulcer disease including bleeding
53441 CHR MARGIN ULC W HEM-OBS Peptic ulcer disease including bleeding
53451 CHR MARGIN ULC PERF-OBST Peptic ulcer disease including bleeding
53461 CHR MARG ULC HEM/PERF-OB Peptic ulcer disease including bleeding
53471 CHR MARGINAL ULC NOS-OBS Peptic ulcer disease including bleeding
53491 GASTROJEJUN ULC NOS-OBST Peptic ulcer disease including bleeding
64200 ESSEN HYPERTEN PREG-UNSP Hypertension, uncomplicated
64201 ESSEN HYPERTEN-DELIVERED Hypertension, uncomplicated
64202 ESSEN HYPERTEN-DEL W P/P Hypertension, uncomplicated
64203 ESSEN HYPERTEN-ANTEPART Hypertension, uncomplicated
64204 ESSEN HYPERTEN-POSTPART Hypertension, uncomplicated
64210 RENAL HYPERTEN PREG-UNSP Hypertension, complicated
64211 RENAL HYPERTEN PG-DELIV Hypertension, complicated
64213 RENAL HYPERTEN-ANTEPART Hypertension, complicated
64214 RENAL HYPERTEN-POSTPART Hypertension, complicated
64220 OLD HYPERTEN PREG-UNSPEC Hypertension, complicated
64221 OLD HYPERTEN NEC-DELIVER Hypertension, complicated
64222 OLD HYPERTEN-DELIV W P/P Hypertension, complicated
64223 OLD HYPERTEN NEC-ANTEPAR Hypertension, complicated
64224 OLD HYPERTEN NEC-POSTPAR Hypertension, complicated
64270 TOX W OLD HYPERTEN-UNSP Hypertension, complicated
64271 TOX W OLD HYPERTEN-DELIV Hypertension, complicated
64272 TOX W OLD HYP-DEL W P/P Hypertension, complicated
64273 TOX W OLD HYPER-ANTEPART Hypertension, complicated
64274 TOX W OLD HYPER-POSTPART Hypertension, complicated
64290 HYPERTEN PREG NOS-UNSPEC Hypertension, complicated
64291 HYPERTENS NOS-DELIVERED Hypertension, complicated
64292 HYPERTENS NOS-DEL W P/P Hypertension, complicated
64293 HYPERTENS NOS-ANTEPARTUM Hypertension, complicated
64294 HYPERTENS NOS-POSTPARTUM Hypertension, complicated
64820 ANEMIA IN PREG-UNSPEC Blood loss anemia
64821 ANEMIA – DELIVERED Blood loss anemia
64822 ANEMIA – DELIVERED W P/P Blood loss anemia
64823 ANEMIA – ANTEPARTUM Blood loss anemia
64824 ANEMIA – POSTPARTUM Blood loss anemia
64830 DRUG DEPEND PREG-UNSPEC Drug abuse
64831 DRUG DEPENDENCE-DELIVER Drug abuse
64832 DRUG DEPENDEN-DEL W P/P Drug abuse
64833 DRUG DEPENDENCE-ANTEPARTUM Drug abuse
64834 DRUG DEPENDENCE-POSTPART Drug abuse
7751 NEONAT DIABETES MELLITUS Diabetes with chronic complications
V561 FT/ADJ XTRCORP DIAL CATH Renal failure
V562 FIT/ADJ PERIT DIAL CATH Renal failure
* ICD-9-CM changes designated with an asterisk are new ICD-9-CM codes introduced in FY2004. All other changes are pre-existing codes that have been added to the software.


Other Changes to Comorbidity Software, FY2004
Comorbidity Description of Change
Cardiac arrhythmias This comorbidity was removed for FY2004, Version 2.0.
Coagulopathy This comorbidity should be dropped when using the AHRQ Patient Safety Indicators.
Diabetes w/o chronic complications In the previous version, this comorbidity was labeled as "Diabetes."
Diabetes w/ chronic complications In the previous version, this comorbidity was labeled as "Diabetes, complicated."
Fluid and electrolyte disorders This comorbidity should be dropped when using the AHRQ Patient Safety Indicators.
 
 
Appendix 2. Definitions of Comorbidity




  1. Congestive heart failure
    ICD-9-CM codes:
    398.91, 402.01, 402.11, 402.91, 404.01, 404.11, 404.91, 428.0-428.9
    Discharge does not have these DRGs: Cardiac (103-112, 115-118, 120-127, 129, 132, 133, 135-143)


  2. Valvular disease
    ICD-9-CM codes:
    093.20-093.24, 394.0-397.1, 424.0-424.91, 746.3-746.6, V42.2, V43.3
    Discharge does not have these DRGs: Cardiac (103-112, 115-118, 120-127, 129, 132, 133, 135-143)


  3. Pulmonary circulation disorders
    ICD-9-CM codes:
    416.0-416.9, 417.9
    Discharge does not have these DRGs: Cardiac (103-112, 115-118, 120-127, 129, 132, 133, 135-143) or COPD asthma (88, 96-98)


  4. Peripheral vascular disorders
    ICD-9-CM codes:
    440.0-440.9, 441.00-441.9, 442.0-442.9, 443.1-443.9, 447.1, 557.1, 557.9, V43.4
    Discharge does not have these DRGs: Peripheral vascular (130, 131)


  5. Hypertension (combine uncomplicated and complicated)
    Hypertension, uncomplicated

    ICD-9-CM codes: 401.1, 401.9, 642.00-642.04
    Discharge does not have these DRGs: No DRGs apply

    Hypertension, complicated
    ICD-9-CM codes: 401.0, 402.00, 402.10, 402.90, 403.00, 403.10, 403.90, 404.00, 404.10, 404.90, 405.01, 405.09, 405.11, 405.19, 405.91, 405.99, 642.10- 462.24, 642.70-642.94
    Discharge does not have these DRGs: Cardiac (103-112, 115-118, 120-127, 129, 132, 133, 135-143) or Renal (302-305, 315-333)


  6. Paralysis
    ICD-9-CM codes:
    342.0-342.12, 342.9-344.9, 438.20-438.53
    Discharge does not have these DRGs: Cerebrovascular (5, 14-17, 524)


  7. Other neurological disorders
    ICD-9-CM codes:
    330.0-331.9, 332.0, 333.4, 333.5, 334.0-335.9, 340, 341.1- 341.9, 345.00-345.11, 345.2-345.3, 345.40-345.91, 348.1, 348.3-348.39, 780.3, 780.39, 784.3
    Discharge does not have these DRGs: Nervous system (1-35, 524)


  8. Chronic pulmonary disease
    ICD-9-CM codes:
    490-492.8, 493.00-493.92, 494-494.1, 495.0-505, 506.4
    Discharge does not have these DRGs: COPD asthma (88, 96-98)


  9. Diabetes, uncomplicated
    ICD-9-CM codes:
    250.00-250.33
    Discharge does not have these DRGs: Diabetes (294, 295)


  10. Diabetes, complicated
    ICD-9-CM codes:
    250.40-250.93
    Discharge does not have these DRGs: Diabetes (294, 295)


  11. Hypothyroidism
    ICD-9-CM codes:
    243-244.2, 244.8, 244.9
    Discharge does not have these DRGs: Thyroid endocrine (290, 300, 301)


  12. Renal failure
    ICD-9-CM codes:
    403.01, 403.11, 403.91, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 585, 586, V42.0, V45.1, V56.0-V56.2, V56.8
    Discharge does not have these DRGs: Kidney transplant, Renal failure/dialysis (302, 316, 317)


  13. Liver disease
    ICD-9-CM codes:
    070.22, 070.23, 070.32, 070.33, 070.44, 070.54, 456.0, 456.1, 456.20, 456.21, 571.0, 571.2, 571.3, 571.40-571.49, 571.5, 571.6, 571.8, 571.9, 572.3, 572.8, V42.7
    Discharge does not have these DRGs: Liver (199-202, 205-208)


  14. Peptic ulcer disease excluding bleeding
    ICD-9-CM codes:
    531.41, 531.51, 531.61, 531.70, 531.71, 531.90, 531.91, 532.41, 532.51, 532.61, 532.70, 531.71, 532.90, 532.91, 533.41, 533.51, 533.61, 533.70, 533.71, 533.90, 533.91, 534.41, 534.51, 534.61, 534.70, 534.71, 534.90, V12.71
    Discharge does not have these DRGs: GI hemorrhage or ulcer (174-178)


  15. AIDS: Acquired immune deficiency syndrome I
    ICD-9-CM codes:
    042-044.9
    Discharge does not have these DRGs: HIV (488, 489, 490)


  16. Lymphoma
    ICD-9-CM codes:
    200.00-202.38, 202.50-203.01, 203.8-203.81, 238.6, 273.3, V10.71, V10.72, V10.79
    Discharge does not have these DRGs: Leukemia/lymphoma (400-414, 473, 492)


  17. Metastatic cancer
    ICD-9-CM codes:
    196.0-199.1
    Discharge does not have these DRGs: Cancer, lymphoma (10, 11, 64, 82, 172, 173, 199, 203, 239, 257-260, 274, 275, 303, 318,319, 338, 344, 346, 347, 354, 355, 357, 363, 366, 367, 406-414)


  18. Solid tumor without metastasis
    ICD-9-CM codes:
    140.0-172.9, 174.0-175.9, 179-195.8, V10.00-V10.59, V10.81- V10.9
    Discharge does not have these DRGs: Cancer, lymphoma (10, 11, 64, 82, 172, 173, 199, 203, 239, 257-260, 274, 275, 303, 318, 319, 338, 344, 346, 347, 354, 355, 357, 363, 366, 367, 406-414)


  19. Rheumatoid arthritis/collagen vascular diseases
    ICD-9-CM codes:
    701.0, 710.0-710.9, 714.0-714.9, 720.0-720.9, 725
    Discharge does not have these DRGs: Connective tissue (240, 241)


  20. Coagulopathy
    ICD-9-CM codes:
    2860-2869, 287.1, 287.3-287.5, 289.81-289.82
    Discharge does not have these DRGs: No DRGs apply


  21. Obesity
    ICD-9-CM codes:
    278.0, 278.00, 278.01
    Discharge does not have these DRGs: Nutrition /metabolic (296-298)


  22. Weight loss
    ICD-9-CM codes:
    260-263.9
    Discharge does not have these DRGs: Nutrition/metabolic (296-298)


  23. Fluid and electrolyte disorders
    ICD-9-CM codes:
    276.0-276.9
    Discharge does not have these DRGs: Nutrition/metabolic (296-298)


  24. Blood loss anemia
    ICD-9-CM codes:
    2800, 648.20-648.24
    Discharge does not have these DRGs: Anemia (395, 396)


  25. Deficiency anemias
    ICD-9-CM codes:
    280.1-281.9, 285.21-285.29, 285.9
    Discharge does not have these DRGs: Anemia (395, 396)


  26. Alcohol abuse
    ICD-9-CM codes:
    291.0-291.3, 291.5, 291.8, 291.81, 291.89, 291.9, 303.00-303.93, 305.00-305.03, V113
    Discharge does not have these DRGs: Alcohol or drug (433-437)


  27. Drug abuse
    ICD-9-CM codes:
    292.0, 292.82-292.89, 292.9, 304.00-304.93, 305.20-305.93, 648.30-648.34
    Discharge does not have these DRGs: Alcohol or drug (433-437)


  28. Psychoses
    ICD-9-CM codes:
    295.00-298.9, 299.10, 299.11
    Discharge does not have these DRGs: No DRGs apply


  29. Depression
    ICD-9-CM codes:
    300.4, 301.12, 309.0, 309.1, 311
    Discharge does not have these DRGs: No DRGs apply

Note: A hierarchy was established between the following pairs of comorbidities: If both uncomplicated diabetes and complicated diabetes are present, count only complicated diabetes. If both solid tumor without metastasis and metastatic cancer are present, count only metastatic cancer.
 
 

Internet Citation: HCUP Comorbidity Software. Healthcare Cost and Utilization Project (HCUP). October 2015. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/reports/methods/2004_1.jsp.
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