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Inpatient Definitions and Methodology

Statistics for the Top 20 Diagnoses

All information in this report is taken from the Medicare Provider Analysis and Review (MedPAR) file which is updated annually by CMS based on the federal fiscal year.  The file includes billing data for 100% of all Medicare fee-for-service claims (IPPS claims) for discharges during the twelve months ending September 30.  The report is based on the most recent period available and is consistent with CMS cell size suppression policies. Only diagnoses with more than ten cases are reported.

The twenty diagnoses appearing on highest numbers of cases are ranked by volume (i.e. sum of principal diagnosis cases plus secondary diagnosis cases). Report totals are not calculated because multiple diagnoses may appear on a claim.

Diag Code
an ICD-9-CM diagnosis code that defines a disease, disorder, symptom, or medical sign for a patient. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify conditions appearing on a Medicare fee-for-service inpatient claim. The International Classification of Diseases is published by the World Health Organization and is revised periodically. The ninth revision is used for the period being reported.
ICD-9-CM Diagnosis Description
description of the ICD-9-CM code being reported.
Cases as Principal Diagnosis
total number of IPPS claims in which the diagnosis is designated as the principal diagnosis. The principal diagnosis for a claim is the condition that occasioned the admission. IPPS claims are Medicare fee-for-service inpatient claims paid under the Inpatient Prospective Payment System.
Cases as Secondary Diagnosis
total number of IPPS claims in which the diagnosis is designated as a secondary diagnosis. A secondary diagnosis is a complication or comorbid condition that appears in addition to the principal diagnosis. Up to 8 secondary diagnoses may be listed on a claim. IPPS claims are Medicare fee-for-service inpatient claims paid under the Inpatient Prospective Payment System.