what is a primary diagnosis

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${&U'w%Dbugs*-|0:NOJB\W&^`>h[*luotg+Rk>#>ud@lX[c$)s I am! Yeah, its confusing. Is the content the same or different? This is not referencing the UB04 fields. HOWEVER, claim information coming from physician claims (i.e. 0000001674 00000 n E.g. Status clean up: %PDF-1.4 % inpatient detail - 1st position comes from the ICD9 code that is stored in the inpatient detail table, column dx1. Use case: Person is admitted with heart and kidney failure. While these two may be the same, this is not always the case as billing rules may require that the coder assigns a different billing diagnosis than the clinician assigned as the encounter diagnosis. EHR, claim, or other data source visit provenance.

They DO have line diagnoses which refer to the specific diagnosis the procedure code was paid for. Just to clarify, that data I have is EHR data. My reasoning is that the condition_occurrence table is linked to visit_occurrence table, and the vo.visit_type_concept_id has the provenance information for the visit record ie. primary admitting). We have the provenance of encounter diagnosis, which is the diagnosis code the provider gives to a patient and billing (not claims) diagnosis, the diagnosis code the hospital uses to bill the insurance company. all numbered condition type are secondary. HOWEVER, claim information coming from physician claims (i.e. 0000060009 00000 n For example, we have things like Pre-op diagnosis and Post-op diagnosis, which people actually want to use, so we need to save them. Good observation on the lack of CONDITION_STATUS_SOURCE_CONCEPT_ID. The classification of a medication depends upon its stated, intended effect when prescribed.

But, basically, these type_concept_ids are very data source specific, and are not representative of standard claim fields. condition_status_concept_id: When the diagnosis in the process of healthcare was derived (Rimmas proposal): Now we need to bake the primary, first, second 34th into it. primary and secondary). Other folks may want to add (or remove) from this list: Others can continue to grow this list as is appropriate to their health care environment. I know we have deviated from the thread header (Primary dx vs Secondary dx) but as long as we have started down the rabbit how of How many different types of diagnoses are there that have potential analytics value (channeling Patrick here), I thought I would enumerate some additional diagnoses to consider. They DO have line diagnoses which refer to the specific diagnosis the procedure code was paid for. Please use the following citation: COVID-19 symptoms means fever of 100.4 degrees Fahrenheit or higher, chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, or diarrhea, unless a licensed health care professional determines the persons symptoms were caused by a known condition other than COVID-19. I dont think we do, but it makes sense. Hb```f``ee`e` Q' qO V^a`I;fS(-kBOE7=bTXlg@uLF9 HDA$8:Lb$O cgQ0A8s>z2 5La 6!z{, ,Se`(`X 30010i,v 0 Rn endstream endobj 348 0 obj 259 endobj 330 0 obj << /Type /Page /Parent 326 0 R /Resources << /ColorSpace << /CS3 332 0 R /CS4 333 0 R /CS5 335 0 R >> /ExtGState << /GS2 344 0 R /GS3 343 0 R >> /Font << /TT2 331 0 R /TT3 338 0 R >> /XObject << /Im1 346 0 R >> /ProcSet [ /PDF /Text /ImageC /ImageI ] >> /Contents 336 0 R /MediaBox [ 0 0 612 792 ] /CropBox [ 0 0 612 792 ] /Rotate 0 /StructParents 0 >> endobj 331 0 obj << /Type /Font /Subtype /TrueType /FirstChar 32 /LastChar 148 /Widths [ 250 0 0 0 0 0 0 0 333 333 0 0 250 333 250 278 500 500 500 500 500 500 500 500 500 500 278 278 0 0 0 0 0 722 667 667 722 611 556 0 722 333 389 0 611 889 722 722 556 0 667 556 611 0 722 0 0 722 0 0 0 0 0 0 0 444 500 444 500 444 333 500 500 278 278 500 278 778 500 500 500 500 333 389 278 500 500 722 500 500 444 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333 333 444 444 ] /Encoding /WinAnsiEncoding /BaseFont /GEHPPA+TimesNewRoman /FontDescriptor 334 0 R >> endobj 332 0 obj [ /ICCBased 342 0 R ] endobj 333 0 obj /DeviceGray endobj 334 0 obj << /Type /FontDescriptor /Ascent 891 /CapHeight 656 /Descent -216 /Flags 34 /FontBBox [ -568 -307 2028 1007 ] /FontName /GEHPPA+TimesNewRoman /ItalicAngle 0 /StemV 94 /XHeight 0 /FontFile2 341 0 R >> endobj 335 0 obj [ /Indexed 332 0 R 32 345 0 R ] endobj 336 0 obj << /Filter /FlateDecode /Length 337 0 R >> stream 0000001285 00000 n from Department of Health, New Jersey State Health Assessment Data Web site: https://nj.gov/health/shad 0000002970 00000 n Licensed mental health professional or "LMHP" means a licensed physician, licensed clinical psychologist, licensed professional counselor, licensed clinical social worker, licensed substance abuse treatment practitioner, licensed marriage and family therapist, or certified psychiatric clinical nurse specialist. But I have never seen any claim dataset available to researchers that provide those codes. Primary diagnosis refers to the first-listed (main) diagnosis. Reason for visit. The difference from a research perspective is that billing diagnoses may be more homogeneous since billing coders are trained to use a specific set of rules for assigning the billing code. Primary care physician or PCP means a Plan Provider who has an independent contractor agreement with HPN to assume responsibility for arranging and coordinating the delivery of Covered Services to Members. NJ State Health Assessment Data, New Jersey Department of Health, PO Box 360, Trenton, NJ 08625-0360, nj.gov/health/shad, Copyright State of New Jersey, 1996-2020. Some claim datasources provide line diagnoses for procedure codes. Since these were one of the first type_concept_ids used, users have used these type_concept_ids for variety of things. Some claim datasources provide line diagnoses for procedure codes. The information provided above is from the Department of Health's NJSHAD web site (https://nj.gov/health/shad). we make inpatient detail - 1st position a secondary diagnosis (many data sources start counting up secondary diagnosis from position#1, with primary diagnosis and admitting diagnosis having their own separate fields). Hmmm Im not sure deprecation will work. In the event that a Members Primary Care Physicians agreement terminates, the Member will be required to select another Primary Care Physician. The concept_ids refer to specific tables (i.e. UB 04 forms) have primary diagnoses. 0000029769 00000 n 0000002659 00000 n Although we still need to preserve the existing concepts in case some data dont have the necessary granularity. !T$,0& {X4l #)Y8^>!+&fmehc^fJ c&a=:j(Yd&%+-jI}~>F642[)D"c2VrnhUI_]G6VW#=/q~i)*p'p%XY x!>i9g\,'5p|n-9SeF#~SHiA8ghc13)&&1W,y08}&n vr^gq~%(,-A>gOHQjEmB}?g-YXE,j=OA0ce"rran>[e<9i K'99Nfrfqj/~zbDa>z \%I{B)iB*i=t=zH? Z9q^v=]IUgsVSgCRG>LotHdtMg.X28K#db4BJ(Gi4Ji-Uth%BXz~"Ed@d@~%ToJUa^76p=]2Meps&,\|&FN8Z9\cjYq' nOE^,/bIddR.,ZIY6{t "Z$aSLY&lT,geqMl#n!wdtjd F18e\p5IeUj/T}ik^iY{uci>,bUJ#$O-,0Cj7Fj)1Y d0juqMaUq1 Q{|o\sk$nP\0BlF.rPgxKa-y1MCE)H1 1&1_T_Xjn/P'/cnqc"~ @snfcUgp/C2 arX". The primary/secondary data also lives in the condition_type_concept_id column. So, when we want to preserve both of the attributes we literally dont have a place for that. I do need to disagree with my my pal @Gowtham_Rao on the following quote: we discourage use of numbered positions for secondary diagnosis. 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HCFA 1500 forms) do not have a primary diagnosis. Then, if everybody agrees, we can proceed with clean up and new concepts creation. 0000002618 00000 n Did we have a convention that we should have only one primary diagnosis per visit ? A doctor may put renal disorder as the primary diagnosis when a patient is admitted and then, after labs and examination, decide that the primary cause is hypertension and renal failure is the complication (e.i. 0000003390 00000 n create precoordinated concepts (e.g. Retrieved The billing coders use specific billing rules and procedures to assign the correct billing code. on this website may be reproduced without permission. 0000063162 00000 n A Primary Care Physicians agreement with HPN may terminate. My recommendations, we still need to preserve the existing concepts in case some data dont have the necessary granularity. As for me, it looks like 2 options: add a column or create precoordinated concepts (e.g. Im looking at the wiki and there is NOT a condition_status_source_concept_id column in the CDM. EHR, condition_status_concept_id = what the data represents, what type or status of diagnosis, secondary (or supplemental if we want to prevent users from thinking secondary = dx2). However, these type_concept_ids are not really representative of claims in general - hence the type_concept_ids are very specific to Truven Marketscan. Yes, line diagnosis is a better descriptor here. DASHBOARD: Single-page comparisons to NJ and US data for counties or racial/ethnic groups, PROFILES: Multi-page reports of health indicators for counties, Marriage, Civil Union, and Domestic Partnership, Vital Events Counts and Rates, 1900-Present, Certain infectious and parasitic diseases, Endocrine, nutritional, and metabolic diseases, and immunity disorders, Diseases of the blood and blood-forming organs, Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism, Endocrine, nutritional, and metabolic diseases, Diseases of the nervous system and sense organs, Diseases of the skin and subcutaneous tissue, Diseases of the musculoskeletal system and connective tissue, Certain conditions originating in the perinatal period, Congenital malformations, deformations, and chromosomal abnormalities, Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified, Injury, poisoning, and certain other consequences of external causes*, Factors influencing health status and contact with health services. Sounds like exactly what I was proposing. I see. https://medical-dictionary.thefreedictionary.com/primary+diagnosis. This is referring to how Marketscan organizes data. 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Each hospitalization record in the Hospital Discharge query may contain up to 13 diagnoses. The treatment path is very different. All content on this website, including dictionary, thesaurus, literature, geography, and other reference data is for informational purposes only.

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