ICDTLB6B ;ALB/EG/MRY/KUM - GROUPER UTILITY FUNCTIONS FY 2006;9/29/03 2:47pm
;;18.0;DRG Grouper;**20,22,64**;Oct 20, 2000;Build 103
;
DRG403 S ICDRG=$S(ICDPD["l":$S(AGE="":470,AGE<18:405,1:473),ICDOR["O"!(ICDORNI["O"):$S(ICDCC:401,1:402),ICDCC:403,1:404),ICDRTC=$S(ICDRG=470:3,1:ICDRTC) Q
DRG404 S ICDRG=$S(ICDPD["l":$S(AGE="":470,AGE<18:405,1:473),ICDOR["O"!(ICDORNI["O"):$S(ICDCC:401,1:402),ICDCC:403,1:404),ICDRTC=$S(ICDRG=470:3,1:ICDRTC) Q
DRG405 D DRG404 Q
DRG406 ;
I ICDORNI["K" D
.S ICDRG=$S((ICDPD["L")&(ICDCC):539,ICDPD["L":540,ICDCC:406,1:407)
I ICDORNI'["K" D DRG408
Q
DRG407 D DRG406 Q
DRG408 I $D(ICDDX(1))&(ICDOPCT=0) D Q:ICDRG=409
.I ICDDX(1)=$$CODEBA^ICDEX("V58.0",80) S ICDRG=409 Q
.I ICDDX(1)=$$CODEBA^ICDEX("V67.1",80) S ICDRG=409 Q
.Q
I $D(ICDDX(1))&(ICDOPCT=0) D Q:"410^492"[ICDRG
.I ICDDX(1)=$$CODEBA^ICDEX("V58.11",80) S ICDRG=$S(ICDSD["2":492,1:410) Q
.I ICDDX(1)=$$CODEBA^ICDEX("V58.12",80) S ICDRG=$S(ICDSD["2":492,1:410) Q
.I ICDDX(1)=$$CODEBA^ICDEX("V67.2",80) S ICDRG=$S(ICDSD["2":492,1:410) Q
I ICDOPCT>0 S ICDRG=$S(ICDPD'["L":408,ICDCC:401,1:402) Q
I ICDOPCT=0 D DRG412
Q
DRG411 S ICDRG=$S(ICDOR["O"!(ICDORNI["O"):408,ICDOR["N":412,1:411) Q
DRG412 ;S ICDRG=$S(ICDOR["O"!(ICDORNI["O"):408,ICDOR["N"&($D(ICDPDRG(412))):412,$D(ICDPDRG(411)):411,ICDCC:413,1:414)
I ICDOPCT>0 D DRG408 Q
D DRG412^ICDTLB61
Q
DRG413 S ICDRG=$S(ICDCC:413,1:414) Q
DRG414 S ICDRG=$S(ICDCC:413,1:414) Q
DRG416 S ICDRG=$S(ICDOR["O":415,AGE="":470,AGE>17:416,1:417),ICDRTC=$S(ICDRG=470:3,1:ICDRTC) Q
DRG417 S ICDRG=$S(ICDOR["O":415,AGE="":470,AGE>17:416,1:417),ICDRTC=$S(ICDRG=470:3,1:ICDRTC) Q
DRG418 S ICDRG=$S(ICDOR["O":415,1:418) Q
DRG419 S ICDRG=$S(ICDOR["O":415,AGE="":470,AGE<18:422,ICDCC:419,1:420),ICDRTC=$S(ICDRG=470:3,1:ICDRTC) Q
DRG420 S ICDRG=$S(ICDOR["O":415,AGE="":470,AGE<18:422,ICDCC:419,1:420),ICDRTC=$S(ICDRG=470:3,1:ICDRTC) Q
DRG421 S ICDRG=$S(ICDOR["O":415,AGE="":470,AGE>17:421,1:422),ICDRTC=$S(ICDRG=470:3,1:ICDRTC) Q
DRG422 S ICDRG=$S(ICDOR["O":415,AGE="":470,AGE>17:421,1:422),ICDRTC=$S(ICDRG=470:3,1:ICDRTC) Q
DRG423 S ICDRG=$S(ICDOR["O":415,1:423) Q
DRG424 S ICDRG=$S(ICDOR["O":424,1:425) Q
DRG425 S ICDRG=$S(ICDOR["O":424,1:425) Q
DRG426 S ICDRG=$S(ICDOR["O":424,1:426) Q
DRG427 S ICDRG=$S(ICDOR["O":424,1:427) Q
DRG428 S ICDRG=$S(ICDOR["O":424,1:428) Q
DRG429 S ICDRG=$S(ICDOR["O":424,1:429) Q
DRG430 S ICDRG=$S(ICDOR["O":424,1:430) Q
DRG431 S ICDRG=$S(ICDOR["O":424,1:431) Q
DRG432 S ICDRG=$S(ICDOR["O":424,1:432) Q
DRG434 S ICDRG=$S(ICDPD["t"!(ICDSD["t"):$S(ICDOR["D":437,ICDOR["R":436,ICDCC:434,1:435),ICDCC:434,1:435) Q
DRG435 S ICDRG=$S(ICDPD["t"!(ICDSD["t"):$S(ICDOR["D":437,ICDOR["R":436,ICDCC:434,1:435),ICDCC:434,1:435) Q
DRG436 S ICDRG=$S(ICDPD["t"!(ICDSD["t"):$S(ICDOR["D":437,ICDOR["R":436,ICDCC:434,1:435),ICDCC:434,1:435) Q
DRG437 S ICDRG=$S(ICDPD["t"!(ICDSD["t"):$S(ICDOR["D":437,ICDOR["R":436,ICDCC:434,1:435),ICDCC:434,1:435) Q
DRG439 S ICDRG=$S($D(ICDODRG(440)):440,1:439) Q
DRG442 S ICDRG=$S(ICDCC:442,1:443) Q
DRG443 D EN1^ICDDRG5 S ICDRG=$S(ICDCC3:$S(ICDCC:442,1:443),1:"") Q
DRG444 S ICDRG=$S(AGE<18:446,ICDCC:444,1:445) I AGE="" S ICDRG=470,ICDRTC=3
Q
DRG445 S ICDRG=$S(AGE<18:446,ICDCC:444,1:445) I AGE="" S ICDRG=470,ICDRTC=3
Q
DRG446 S ICDRG=$S(AGE<18:446,ICDCC:444,1:445) I AGE="" S ICDRG=470,ICDRTC=3
Q
DRG447 S ICDRG=$S(AGE>17:447,1:448) I AGE="" S ICDRG=470,ICDRTC=3
Q
DRG448 S ICDRG=$S(AGE>17:447,1:448) I AGE="" S ICDRG=470,ICDRTC=3
Q
DRG449 S ICDRG=$S(AGE<18:451,ICDCC:449,1:450) I AGE="" S ICDRG=470,ICDRTC=3
Q
DRG450 S ICDRG=$S(AGE<18:451,ICDCC:449,1:450) I AGE="" S ICDRG=470,ICDRTC=3
Q
DRG451 S ICDRG=$S(AGE<18:451,ICDCC:449,1:450) I AGE="" S ICDRG=470,ICDRTC=3
Q
DRG452 S ICDRG=$S(ICDCC:452,1:453) Q
DRG453 S ICDRG=$S(ICDCC:452,1:453) Q
DRG454 S ICDRG=$S(ICDCC:454,1:455) Q
DRG455 S ICDRG=$S(ICDCC:454,1:455) Q
DRG462 S ICDRG=$S(ICDOR["O":461,1:462) Q
DRG463 S ICDRG=$S(ICDOR["O":461,ICDCC:463,1:464) Q
DRG464 S ICDRG=$S(ICDOR["O":461,ICDCC:463,1:464) Q
DRG465 S ICDRG=$S(ICDOR["O":461,ICDSD["m":465,1:466) Q
DRG466 S ICDRG=$S(ICDOR["O":461,ICDSD["m":465,1:466) Q
DRG467 S ICDRG=$S(ICDOR["O":461,1:467) Q
DRG471 S ICDRG=$S($F($P(ICDOR,"M",2,99),"M"):471,1:"") Q
DRG475 S ICDRG=$S(ICDOR["V":475,1:$S($D(ICDPDRG):$O(ICDPDRG(0)),1:468)) I ICDRG<468 D DODRG^ICDDRG0
Q
DRG478 S ICDRG=$S(ICDOR["O"&ICDCC:478,1:479)
I ICDRG=478 D DRG553^ICDTLB6B
Q
DRG479 G DRG478
DRG493 ;I (ICDI-1)=1,'ICDCC S ICDCC=$S($D(^ICD9("ACC",ICDDX(1),ICDDX(1))):1,1:0)
S ICDRG=$S(ICDCC:493,1:494) Q
DRG494 ;I (ICD-1),'ICDCC S ICDCC=$S($D(^ICD9("ACC",ICDDX(1),ICDDX(1))):1,1:0)
S ICDRG=$S(ICDCC:493,1:494) Q
DRG495 Q
DRG496 S ICDRG=$S(ICDOR["F":496,ICDCC:497,1:498)
I ICDRG=497!(ICDRG=498) I ICDPD["6" S ICDRG=546 Q
I ICDRG=497!(ICDRG=498) I $D(ICDDXT("737.40"))!($D(ICDDXT("737.41")))!($D(ICDDXT("737.42")))!($D(ICDDXT("737.43"))) S ICDRG=546
Q
DRG497 G DRG496 ;S ICDRG=$S(ICDOR["F":496,ICDCC:497,1:498) Q
DRG498 G DRG496 ;S ICDRG=$S(ICDOR["F":496,ICDCC:497,1:498) Q
DRG499 S ICDRG=$S(ICDCC:499,1:500) Q
DRG500 S ICDRG=$S(ICDCC:499,1:500) Q
DRG501 D
. I (ICDPD["k") D
.. I ICDCC S ICDRG=501
.. I 'ICDCC S ICDRG=502
. E S ICDRG=503
Q
DRG502 D DRG501 Q
DRG503 D DRG501 Q
DRG514 ; Replaced with DRG535
N ICDE1,ICDE2
S ICDE1=$S($D(ICDOP(" 37.95"))&($D(ICDOP(" 37.96"))):1,1:0)
S ICDE2=$S($D(ICDOP(" 37.97"))&($D(ICDOP(" 37.98"))):1,1:0)
S ICDRG=470
I $D(ICDOP(" 37.94")) I ICDE1+ICDE2=0 S ICDRG=515
I '$D(ICDOP(" 37.94")) I ICDE1!ICDE2 S ICDRG=515
; "HN" in ICDOR represents OR proc 37.21-.23, 37.26, 88.52-.58
I ICDRG=515 I ICDOR["HN" S ICDRG=514
Q
DRG515 D DRG535 Q
DRG516 ; DRG 516,517,526 and 527 replaced by DRG 555-558 respectively
S ICDRG=518
D DRG555
I $D(ICDOP(" 36.06"))!$D(ICDOP(" 92.27")) D DRG556
I $D(ICDOP(" 36.07")) D DRG557
Q
DRG517 D DRG516 Q
DRG518 D DRG516 Q
DRG519 S ICDRG=$S(ICDOR["F":496,ICDCC:519,1:520) Q
DRG520 D DRG519 Q
DRG521 S ICDRG=$S(ICDCC:521,ICDOR["D"!(ICDOR["R"):522,1:523) Q
DRG522 D DRG521 Q
DRG523 D DRG521 Q
DRG526 D DRG516 Q
DRG527 D DRG516 Q
DRG531 S ICDRG=$S(ICDCC:531,1:532) Q
DRG532 D DRG531 Q
DRG533 S ICDRG=$S(ICDCC:533,1:534) Q
DRG534 D DRG533 Q
DRG535 N ICDE1,ICDE2,ICDE3
S ICDE1=$S($D(ICDOP(" 37.95"))&(($D(ICDOP(" 37.96")))!($D(ICDOP(" 00.54")))):1,1:0)
S ICDE2=$S($D(ICDOP(" 37.97"))&(($D(ICDOP(" 37.98")))!($D(ICDOP(" 00.54")))):1,1:0)
S ICDE3=$S($D(ICDOP(" 00.52"))&($D(ICDOP(" 00.54"))):1,1:0)
;S ICDE4=$S($D(ICDOP(" 00.54"))&($D(ICDOP(" 37.95"))):1,1:0)
S ICDRG=470
I $D(ICDOP(" 37.94"))!$D(ICDOP(" 00.51")) I ICDE1+ICDE2+ICDE3=0 S ICDRG=515
I '$D(ICDOP(" 37.94"))&('$D(ICDOP(" 00.51"))) I ICDE1!ICDE2!ICDE3 S ICDRG=515
; "HN" in ICDOR represents OR proc 37.21-.23, 37.26, 88.52-.58
I ICDRG=515 I ICDOR["HN" I '$D(ICDOP(" 37.26")) S ICDRG=$S(ICDPD["A":535,1:536)
I ICDRG=470 D DRG115^ICDTLB2B
Q
DRG536 D DRG535 Q
DRG537 S ICDRG=$S(ICDCC:537,1:538) Q
DRG538 D DRG537 Q
DRG539 I ICDPD["L"&(ICDMAJ'[3) D DRG401^ICDTLB5B Q:"401^402^403^404^405^470^473"[ICDRG
S ICDRG=$S((ICDPD["L")&(ICDCC):539,ICDPD["L":540,ICDCC:406,1:407) Q
DRG540 D DRG539 Q
DRG543 S ICDRG=$S((ICDPD["Q")&(ICDOR["Q"):543,ICDOR["Q"&$D(ICDOP(" 00.10")):543,1:ICDRG) Q
DRG544 Q
DRG545 Q
DRG546 Q
DRG547 ; called from DRG106^ICDTLB2B
D MCV
S ICDRG=$S(ICDMCV:547,ICDMCV1:547,1:548) Q
DRG548 G DRG547
DRG549 ; called from DRG106^ICDTLB2B
D MCV
S ICDRG=$S(ICDMCV:549,ICDMCV1:549,1:550) Q
DRG550 G DRG549
DRG551 ; called from DRG115^ICDTLB2B
D MCV
I ICDMCV!(ICDMCV2) S ICDRG=551
Q
DRG552 Q
DRG553 ; called from DRG478
D MCV
S ICDRG=$S(ICDMCV:553,ICDMCV1:553,1:554) Q
DRG554 G DRG553
DRG555 ; called from DRG516
D MCV
I ICDMCV!(ICDMCV1) S ICDRG=555
Q
DRG556 ; called from DRG516
D MCV
I 'ICDMCV&('ICDMCV1) S ICDRG=556
Q
DRG557 ; called from DRG516
D MCV
I ICDMCV!ICDMCV1 S ICDRG=557
E S ICDRG=558
Q
DRG558 G DRG516
DRG559 ;I DGDX(1)["433.01"!(DGDX(1)["433.11")!(DGDX(1)["433.21")!(DGDX(1)["433.31")!(DGDX(1)["433.81")!(DGDX(1)["433.91")!(DGDX(1)["434.01")!(DGDX(1)["434.11")!(DGDX(1)["434.91") S ICDRG=559
I $G(ICDDX(1))=12856!($G(ICDDX(1))=12858)!($G(ICDDX(1))=12860)!($G(ICDDX(1))=12862)!($G(ICDDX(1))=12864)!($G(ICDDX(1))=12866)!($G(ICDDX(1))=12868)!($G(ICDDX(1))=12870)!($G(ICDDX(1))=12872) S ICDRG=559
Q
MCV ; checks to see if case qualifies as an MCV (major cardiovascular complications or complex conditions)
S (ICDMCV,ICDMCV1,ICDMCV2)=0
; ICDPD=identifier for prime dx ICDSD=identifier for any secondary dx
; DGDX(1)=prime dx ICDDX(1)=ien of prime dx ICDDXT=any secondary dx
I ICDPD["c"!(ICDSD["c") S ICDMCV=1
I ICDSD["s" S ICDMCV=1
;I DGDX(1)["426.0"!(DGDX(1)["426.53")!(DGDX(1)["426.54") S ICDMCV1=1
I $G(ICDDX(1))=9056!($G(ICDDX(1))=2548)!($G(ICDDX(1))=2549) S ICDMCV1=1
I $D(ICDDXT("426.0"))!($D(ICDDXT("426.53")))!($D(ICDDXT("426.54"))) S ICDMCV1=1
;I DGDX(1)["411.1"!(DGDX(1)["411.81") S ICDMCV2=1
I $G(ICDDX(1))=2500!($G(ICDDX(1))=12477) S ICDMCV2=1
I $D(ICDDXT("411.1"))!($D(ICDDXT("411.81"))) S ICDMCV2=1
Q
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HICDTLB6B 9104 printed Sep 23, 2025@19:28:45 Page 2
ICDTLB6B ;ALB/EG/MRY/KUM - GROUPER UTILITY FUNCTIONS FY 2006;9/29/03 2:47pm
+1 ;;18.0;DRG Grouper;**20,22,64**;Oct 20, 2000;Build 103
+2 ;
DRG403 SET ICDRG=$SELECT(ICDPD["l":$SELECT(AGE="":470,AGE<18:405,1:473),ICDOR["O"!(ICDORNI["O"):$SELECT(ICDCC:401,1:402),ICDCC:403,1:404)
SET ICDRTC=$SELECT(ICDRG=470:3,1:ICDRTC)
QUIT
DRG404 SET ICDRG=$SELECT(ICDPD["l":$SELECT(AGE="":470,AGE<18:405,1:473),ICDOR["O"!(ICDORNI["O"):$SELECT(ICDCC:401,1:402),ICDCC:403,1:404)
SET ICDRTC=$SELECT(ICDRG=470:3,1:ICDRTC)
QUIT
DRG405 DO DRG404
QUIT
DRG406 ;
+1 IF ICDORNI["K"
Begin DoDot:1
+2 SET ICDRG=$SELECT((ICDPD["L")&(ICDCC):539,ICDPD["L":540,ICDCC:406,1:407)
End DoDot:1
+3 IF ICDORNI'["K"
DO DRG408
+4 QUIT
DRG407 DO DRG406
QUIT
DRG408 IF $DATA(ICDDX(1))&(ICDOPCT=0)
Begin DoDot:1
+1 IF ICDDX(1)=$$CODEBA^ICDEX("V58.0",80)
SET ICDRG=409
QUIT
+2 IF ICDDX(1)=$$CODEBA^ICDEX("V67.1",80)
SET ICDRG=409
QUIT
+3 QUIT
End DoDot:1
if ICDRG=409
QUIT
+4 IF $DATA(ICDDX(1))&(ICDOPCT=0)
Begin DoDot:1
+5 IF ICDDX(1)=$$CODEBA^ICDEX("V58.11",80)
SET ICDRG=$SELECT(ICDSD["2":492,1:410)
QUIT
+6 IF ICDDX(1)=$$CODEBA^ICDEX("V58.12",80)
SET ICDRG=$SELECT(ICDSD["2":492,1:410)
QUIT
+7 IF ICDDX(1)=$$CODEBA^ICDEX("V67.2",80)
SET ICDRG=$SELECT(ICDSD["2":492,1:410)
QUIT
End DoDot:1
if "410^492"[ICDRG
QUIT
+8 IF ICDOPCT>0
SET ICDRG=$SELECT(ICDPD'["L":408,ICDCC:401,1:402)
QUIT
+9 IF ICDOPCT=0
DO DRG412
+10 QUIT
DRG411 SET ICDRG=$SELECT(ICDOR["O"!(ICDORNI["O"):408,ICDOR["N":412,1:411)
QUIT
DRG412 ;S ICDRG=$S(ICDOR["O"!(ICDORNI["O"):408,ICDOR["N"&($D(ICDPDRG(412))):412,$D(ICDPDRG(411)):411,ICDCC:413,1:414)
+1 IF ICDOPCT>0
DO DRG408
QUIT
+2 DO DRG412^ICDTLB61
+3 QUIT
DRG413 SET ICDRG=$SELECT(ICDCC:413,1:414)
QUIT
DRG414 SET ICDRG=$SELECT(ICDCC:413,1:414)
QUIT
DRG416 SET ICDRG=$SELECT(ICDOR["O":415,AGE="":470,AGE>17:416,1:417)
SET ICDRTC=$SELECT(ICDRG=470:3,1:ICDRTC)
QUIT
DRG417 SET ICDRG=$SELECT(ICDOR["O":415,AGE="":470,AGE>17:416,1:417)
SET ICDRTC=$SELECT(ICDRG=470:3,1:ICDRTC)
QUIT
DRG418 SET ICDRG=$SELECT(ICDOR["O":415,1:418)
QUIT
DRG419 SET ICDRG=$SELECT(ICDOR["O":415,AGE="":470,AGE<18:422,ICDCC:419,1:420)
SET ICDRTC=$SELECT(ICDRG=470:3,1:ICDRTC)
QUIT
DRG420 SET ICDRG=$SELECT(ICDOR["O":415,AGE="":470,AGE<18:422,ICDCC:419,1:420)
SET ICDRTC=$SELECT(ICDRG=470:3,1:ICDRTC)
QUIT
DRG421 SET ICDRG=$SELECT(ICDOR["O":415,AGE="":470,AGE>17:421,1:422)
SET ICDRTC=$SELECT(ICDRG=470:3,1:ICDRTC)
QUIT
DRG422 SET ICDRG=$SELECT(ICDOR["O":415,AGE="":470,AGE>17:421,1:422)
SET ICDRTC=$SELECT(ICDRG=470:3,1:ICDRTC)
QUIT
DRG423 SET ICDRG=$SELECT(ICDOR["O":415,1:423)
QUIT
DRG424 SET ICDRG=$SELECT(ICDOR["O":424,1:425)
QUIT
DRG425 SET ICDRG=$SELECT(ICDOR["O":424,1:425)
QUIT
DRG426 SET ICDRG=$SELECT(ICDOR["O":424,1:426)
QUIT
DRG427 SET ICDRG=$SELECT(ICDOR["O":424,1:427)
QUIT
DRG428 SET ICDRG=$SELECT(ICDOR["O":424,1:428)
QUIT
DRG429 SET ICDRG=$SELECT(ICDOR["O":424,1:429)
QUIT
DRG430 SET ICDRG=$SELECT(ICDOR["O":424,1:430)
QUIT
DRG431 SET ICDRG=$SELECT(ICDOR["O":424,1:431)
QUIT
DRG432 SET ICDRG=$SELECT(ICDOR["O":424,1:432)
QUIT
DRG434 SET ICDRG=$SELECT(ICDPD["t"!(ICDSD["t"):$SELECT(ICDOR["D":437,ICDOR["R":436,ICDCC:434,1:435),ICDCC:434,1:435)
QUIT
DRG435 SET ICDRG=$SELECT(ICDPD["t"!(ICDSD["t"):$SELECT(ICDOR["D":437,ICDOR["R":436,ICDCC:434,1:435),ICDCC:434,1:435)
QUIT
DRG436 SET ICDRG=$SELECT(ICDPD["t"!(ICDSD["t"):$SELECT(ICDOR["D":437,ICDOR["R":436,ICDCC:434,1:435),ICDCC:434,1:435)
QUIT
DRG437 SET ICDRG=$SELECT(ICDPD["t"!(ICDSD["t"):$SELECT(ICDOR["D":437,ICDOR["R":436,ICDCC:434,1:435),ICDCC:434,1:435)
QUIT
DRG439 SET ICDRG=$SELECT($DATA(ICDODRG(440)):440,1:439)
QUIT
DRG442 SET ICDRG=$SELECT(ICDCC:442,1:443)
QUIT
DRG443 DO EN1^ICDDRG5
SET ICDRG=$SELECT(ICDCC3:$SELECT(ICDCC:442,1:443),1:"")
QUIT
DRG444 SET ICDRG=$SELECT(AGE<18:446,ICDCC:444,1:445)
IF AGE=""
SET ICDRG=470
SET ICDRTC=3
+1 QUIT
DRG445 SET ICDRG=$SELECT(AGE<18:446,ICDCC:444,1:445)
IF AGE=""
SET ICDRG=470
SET ICDRTC=3
+1 QUIT
DRG446 SET ICDRG=$SELECT(AGE<18:446,ICDCC:444,1:445)
IF AGE=""
SET ICDRG=470
SET ICDRTC=3
+1 QUIT
DRG447 SET ICDRG=$SELECT(AGE>17:447,1:448)
IF AGE=""
SET ICDRG=470
SET ICDRTC=3
+1 QUIT
DRG448 SET ICDRG=$SELECT(AGE>17:447,1:448)
IF AGE=""
SET ICDRG=470
SET ICDRTC=3
+1 QUIT
DRG449 SET ICDRG=$SELECT(AGE<18:451,ICDCC:449,1:450)
IF AGE=""
SET ICDRG=470
SET ICDRTC=3
+1 QUIT
DRG450 SET ICDRG=$SELECT(AGE<18:451,ICDCC:449,1:450)
IF AGE=""
SET ICDRG=470
SET ICDRTC=3
+1 QUIT
DRG451 SET ICDRG=$SELECT(AGE<18:451,ICDCC:449,1:450)
IF AGE=""
SET ICDRG=470
SET ICDRTC=3
+1 QUIT
DRG452 SET ICDRG=$SELECT(ICDCC:452,1:453)
QUIT
DRG453 SET ICDRG=$SELECT(ICDCC:452,1:453)
QUIT
DRG454 SET ICDRG=$SELECT(ICDCC:454,1:455)
QUIT
DRG455 SET ICDRG=$SELECT(ICDCC:454,1:455)
QUIT
DRG462 SET ICDRG=$SELECT(ICDOR["O":461,1:462)
QUIT
DRG463 SET ICDRG=$SELECT(ICDOR["O":461,ICDCC:463,1:464)
QUIT
DRG464 SET ICDRG=$SELECT(ICDOR["O":461,ICDCC:463,1:464)
QUIT
DRG465 SET ICDRG=$SELECT(ICDOR["O":461,ICDSD["m":465,1:466)
QUIT
DRG466 SET ICDRG=$SELECT(ICDOR["O":461,ICDSD["m":465,1:466)
QUIT
DRG467 SET ICDRG=$SELECT(ICDOR["O":461,1:467)
QUIT
DRG471 SET ICDRG=$SELECT($FIND($PIECE(ICDOR,"M",2,99),"M"):471,1:"")
QUIT
DRG475 SET ICDRG=$SELECT(ICDOR["V":475,1:$SELECT($DATA(ICDPDRG):$ORDER(ICDPDRG(0)),1:468))
IF ICDRG<468
DO DODRG^ICDDRG0
+1 QUIT
DRG478 SET ICDRG=$SELECT(ICDOR["O"&ICDCC:478,1:479)
+1 IF ICDRG=478
DO DRG553^ICDTLB6B
+2 QUIT
DRG479 GOTO DRG478
DRG493 ;I (ICDI-1)=1,'ICDCC S ICDCC=$S($D(^ICD9("ACC",ICDDX(1),ICDDX(1))):1,1:0)
+1 SET ICDRG=$SELECT(ICDCC:493,1:494)
QUIT
DRG494 ;I (ICD-1),'ICDCC S ICDCC=$S($D(^ICD9("ACC",ICDDX(1),ICDDX(1))):1,1:0)
+1 SET ICDRG=$SELECT(ICDCC:493,1:494)
QUIT
DRG495 QUIT
DRG496 SET ICDRG=$SELECT(ICDOR["F":496,ICDCC:497,1:498)
+1 IF ICDRG=497!(ICDRG=498)
IF ICDPD["6"
SET ICDRG=546
QUIT
+2 IF ICDRG=497!(ICDRG=498)
IF $DATA(ICDDXT("737.40"))!($DATA(ICDDXT("737.41")))!($DATA(ICDDXT("737.42")))!($DATA(ICDDXT("737.43")))
SET ICDRG=546
+3 QUIT
DRG497 ;S ICDRG=$S(ICDOR["F":496,ICDCC:497,1:498) Q
GOTO DRG496
DRG498 ;S ICDRG=$S(ICDOR["F":496,ICDCC:497,1:498) Q
GOTO DRG496
DRG499 SET ICDRG=$SELECT(ICDCC:499,1:500)
QUIT
DRG500 SET ICDRG=$SELECT(ICDCC:499,1:500)
QUIT
DRG501 Begin DoDot:1
+1 IF (ICDPD["k")
Begin DoDot:2
+2 IF ICDCC
SET ICDRG=501
+3 IF 'ICDCC
SET ICDRG=502
End DoDot:2
+4 IF '$TEST
SET ICDRG=503
End DoDot:1
+5 QUIT
DRG502 DO DRG501
QUIT
DRG503 DO DRG501
QUIT
DRG514 ; Replaced with DRG535
+1 NEW ICDE1,ICDE2
+2 SET ICDE1=$SELECT($DATA(ICDOP(" 37.95"))&($DATA(ICDOP(" 37.96"))):1,1:0)
+3 SET ICDE2=$SELECT($DATA(ICDOP(" 37.97"))&($DATA(ICDOP(" 37.98"))):1,1:0)
+4 SET ICDRG=470
+5 IF $DATA(ICDOP(" 37.94"))
IF ICDE1+ICDE2=0
SET ICDRG=515
+6 IF '$DATA(ICDOP(" 37.94"))
IF ICDE1!ICDE2
SET ICDRG=515
+7 ; "HN" in ICDOR represents OR proc 37.21-.23, 37.26, 88.52-.58
+8 IF ICDRG=515
IF ICDOR["HN"
SET ICDRG=514
+9 QUIT
DRG515 DO DRG535
QUIT
DRG516 ; DRG 516,517,526 and 527 replaced by DRG 555-558 respectively
+1 SET ICDRG=518
+2 DO DRG555
+3 IF $DATA(ICDOP(" 36.06"))!$DATA(ICDOP(" 92.27"))
DO DRG556
+4 IF $DATA(ICDOP(" 36.07"))
DO DRG557
+5 QUIT
DRG517 DO DRG516
QUIT
DRG518 DO DRG516
QUIT
DRG519 SET ICDRG=$SELECT(ICDOR["F":496,ICDCC:519,1:520)
QUIT
DRG520 DO DRG519
QUIT
DRG521 SET ICDRG=$SELECT(ICDCC:521,ICDOR["D"!(ICDOR["R"):522,1:523)
QUIT
DRG522 DO DRG521
QUIT
DRG523 DO DRG521
QUIT
DRG526 DO DRG516
QUIT
DRG527 DO DRG516
QUIT
DRG531 SET ICDRG=$SELECT(ICDCC:531,1:532)
QUIT
DRG532 DO DRG531
QUIT
DRG533 SET ICDRG=$SELECT(ICDCC:533,1:534)
QUIT
DRG534 DO DRG533
QUIT
DRG535 NEW ICDE1,ICDE2,ICDE3
+1 SET ICDE1=$SELECT($DATA(ICDOP(" 37.95"))&(($DATA(ICDOP(" 37.96")))!($DATA(ICDOP(" 00.54")))):1,1:0)
+2 SET ICDE2=$SELECT($DATA(ICDOP(" 37.97"))&(($DATA(ICDOP(" 37.98")))!($DATA(ICDOP(" 00.54")))):1,1:0)
+3 SET ICDE3=$SELECT($DATA(ICDOP(" 00.52"))&($DATA(ICDOP(" 00.54"))):1,1:0)
+4 ;S ICDE4=$S($D(ICDOP(" 00.54"))&($D(ICDOP(" 37.95"))):1,1:0)
+5 SET ICDRG=470
+6 IF $DATA(ICDOP(" 37.94"))!$DATA(ICDOP(" 00.51"))
IF ICDE1+ICDE2+ICDE3=0
SET ICDRG=515
+7 IF '$DATA(ICDOP(" 37.94"))&('$DATA(ICDOP(" 00.51")))
IF ICDE1!ICDE2!ICDE3
SET ICDRG=515
+8 ; "HN" in ICDOR represents OR proc 37.21-.23, 37.26, 88.52-.58
+9 IF ICDRG=515
IF ICDOR["HN"
IF '$DATA(ICDOP(" 37.26"))
SET ICDRG=$SELECT(ICDPD["A":535,1:536)
+10 IF ICDRG=470
DO DRG115^ICDTLB2B
+11 QUIT
DRG536 DO DRG535
QUIT
DRG537 SET ICDRG=$SELECT(ICDCC:537,1:538)
QUIT
DRG538 DO DRG537
QUIT
DRG539 IF ICDPD["L"&(ICDMAJ'[3)
DO DRG401^ICDTLB5B
if "401^402^403^404^405^470^473"[ICDRG
QUIT
+1 SET ICDRG=$SELECT((ICDPD["L")&(ICDCC):539,ICDPD["L":540,ICDCC:406,1:407)
QUIT
DRG540 DO DRG539
QUIT
DRG543 SET ICDRG=$SELECT((ICDPD["Q")&(ICDOR["Q"):543,ICDOR["Q"&$DATA(ICDOP(" 00.10")):543,1:ICDRG)
QUIT
DRG544 QUIT
DRG545 QUIT
DRG546 QUIT
DRG547 ; called from DRG106^ICDTLB2B
+1 DO MCV
+2 SET ICDRG=$SELECT(ICDMCV:547,ICDMCV1:547,1:548)
QUIT
DRG548 GOTO DRG547
DRG549 ; called from DRG106^ICDTLB2B
+1 DO MCV
+2 SET ICDRG=$SELECT(ICDMCV:549,ICDMCV1:549,1:550)
QUIT
DRG550 GOTO DRG549
DRG551 ; called from DRG115^ICDTLB2B
+1 DO MCV
+2 IF ICDMCV!(ICDMCV2)
SET ICDRG=551
+3 QUIT
DRG552 QUIT
DRG553 ; called from DRG478
+1 DO MCV
+2 SET ICDRG=$SELECT(ICDMCV:553,ICDMCV1:553,1:554)
QUIT
DRG554 GOTO DRG553
DRG555 ; called from DRG516
+1 DO MCV
+2 IF ICDMCV!(ICDMCV1)
SET ICDRG=555
+3 QUIT
DRG556 ; called from DRG516
+1 DO MCV
+2 IF 'ICDMCV&('ICDMCV1)
SET ICDRG=556
+3 QUIT
DRG557 ; called from DRG516
+1 DO MCV
+2 IF ICDMCV!ICDMCV1
SET ICDRG=557
+3 IF '$TEST
SET ICDRG=558
+4 QUIT
DRG558 GOTO DRG516
DRG559 ;I DGDX(1)["433.01"!(DGDX(1)["433.11")!(DGDX(1)["433.21")!(DGDX(1)["433.31")!(DGDX(1)["433.81")!(DGDX(1)["433.91")!(DGDX(1)["434.01")!(DGDX(1)["434.11")!(DGDX(1)["434.91") S ICDRG=559
+1 IF $GET(ICDDX(1))=12856!($GET(ICDDX(1))=12858)!($GET(ICDDX(1))=12860)!($GET(ICDDX(1))=12862)!($GET(ICDDX(1))=12864)!($GET(ICDDX(1))=12866)!($GET(ICDDX(1))=12868)!($GET(ICDDX(1))=12870)!($GET(ICDDX(1))=12872)
SET ICDRG=559
+2 QUIT
MCV ; checks to see if case qualifies as an MCV (major cardiovascular complications or complex conditions)
+1 SET (ICDMCV,ICDMCV1,ICDMCV2)=0
+2 ; ICDPD=identifier for prime dx ICDSD=identifier for any secondary dx
+3 ; DGDX(1)=prime dx ICDDX(1)=ien of prime dx ICDDXT=any secondary dx
+4 IF ICDPD["c"!(ICDSD["c")
SET ICDMCV=1
+5 IF ICDSD["s"
SET ICDMCV=1
+6 ;I DGDX(1)["426.0"!(DGDX(1)["426.53")!(DGDX(1)["426.54") S ICDMCV1=1
+7 IF $GET(ICDDX(1))=9056!($GET(ICDDX(1))=2548)!($GET(ICDDX(1))=2549)
SET ICDMCV1=1
+8 IF $DATA(ICDDXT("426.0"))!($DATA(ICDDXT("426.53")))!($DATA(ICDDXT("426.54")))
SET ICDMCV1=1
+9 ;I DGDX(1)["411.1"!(DGDX(1)["411.81") S ICDMCV2=1
+10 IF $GET(ICDDX(1))=2500!($GET(ICDDX(1))=12477)
SET ICDMCV2=1
+11 IF $DATA(ICDDXT("411.1"))!($DATA(ICDDXT("411.81")))
SET ICDMCV2=1
+12 QUIT
