Top MS-DRG and ICD-9 Codes for Home Health Episodes, By State: Prepared for the Alliance for Home Health Quality and Innovation

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1 Top MS-DRG and ICD-9 Codes for Home Health Episodes, By State: Prepared for the Alliance for Home Health Quality and Innovation November 2014 avalere.com

2 Top 10 MS-DRG Codes for Home Health Episodes, Alabama Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 4, % w/o mcc Septicemia or severe sepsis w/o mv 96+ hours w mcc % Hip & femur procedures except major joint w cc % Heart failure & shock w cc % Intracranial hemorrhage or cerebral infarction w cc % Kidney & urinary tract infections w/o mcc % Heart failure & shock w mcc % Simple pneumonia & pleurisy w cc % Chronic obstructive pulmonary disease w mcc % Cellulitis w/o mcc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 2

3 Top 10 ICD-9 Diagnoses for Home Health Episodes, Alabama Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Other orthopedic aftercare 11, % Diabetes mellitus 11, % Heart failure 10, % Essential hypertension 8, % Other and unspecified aftercare 7, % Care involving use of rehabilitation procedures 7, % Chronic ulcer of skin 6, % Chronic bronchitis 6, % Other deficiency anemias 6, % Late effects of cerebrovascular disease 5, % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

4 Top 10 MS-DRG Codes for Home Health Episodes, Alaska Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity % w/o mcc Intracranial hemorrhage or cerebral infarction w cc % Hip & femur procedures except major joint w cc % Septicemia or severe sepsis w/o mv 96+ hours w mcc % Kidney & urinary tract infections w/o mcc % Septicemia or severe sepsis w/o mv 96+ hours w/o mcc % Bilateral or multiple major joint procs of lower extremity w/o % mcc Simple pneumonia & pleurisy w cc % Heart failure & shock w cc % Revision of hip or knee replacement w cc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 4

5 Top 10 ICD-9 Diagnoses for Home Health Episodes, Alaska Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Care involving use of rehabilitation procedures % Other orthopedic aftercare % Chronic ulcer of skin % Other and unspecified aftercare % Late effects of cerebrovascular disease % Diabetes mellitus % Heart failure % Other complications of procedures, not elsewhere classified % Fitting and adjustment of other device % Attention to artificial openings % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

6 Top 10 MS-DRG Codes for Home Health Episodes, Arizona Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 3, % w/o mcc Septicemia or severe sepsis w/o mv 96+ hours w mcc % Hip & femur procedures except major joint w cc % Cellulitis w/o mcc % Heart failure & shock w cc % Heart failure & shock w mcc % Septicemia or severe sepsis w/o mv 96+ hours w/o mcc % Simple pneumonia & pleurisy w cc % Renal failure w cc % Kidney & urinary tract infections w/o mcc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 6

7 Top 10 ICD-9 Diagnoses for Home Health Episodes, Arizona Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Other orthopedic aftercare 7, % Care involving use of rehabilitation procedures 6, % Other and unspecified aftercare 4, % Chronic ulcer of skin 2, % Diabetes mellitus 2, % Heart failure 2, % Disorders of muscle, ligament, and fascia 1, % Late effects of cerebrovascular disease 1, % Symptoms involving nervous and musculoskeletal systems 1, % Fitting and adjustment of other device 1, % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

8 Top 10 MS-DRG Codes for Home Health Episodes, Arkansas Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 2, % w/o mcc Septicemia or severe sepsis w/o mv 96+ hours w mcc % Heart failure & shock w cc % Hip & femur procedures except major joint w cc % Intracranial hemorrhage or cerebral infarction w cc % Simple pneumonia & pleurisy w cc % Heart failure & shock w mcc % Kidney & urinary tract infections w/o mcc % Cellulitis w/o mcc % Simple pneumonia & pleurisy w mcc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 8

9 Top 10 ICD-9 Diagnoses for Home Health Episodes, Arkansas Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Diabetes mellitus 5, % Other orthopedic aftercare 5, % Heart failure 4, % Care involving use of rehabilitation procedures 4, % Essential hypertension 3, % Chronic ulcer of skin 3, % Other and unspecified aftercare 3, % Chronic bronchitis 2, % Late effects of cerebrovascular disease 2, % Other deficiency anemias 1, % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

10 Top 10 MS-DRG Codes for Home Health Episodes, California Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 15, % w/o mcc Septicemia or severe sepsis w/o mv 96+ hours w mcc 6, % Heart failure & shock w mcc 2, % Hip & femur procedures except major joint w cc 2, % Heart failure & shock w cc 2, % Kidney & urinary tract infections w/o mcc 2, % Intracranial hemorrhage or cerebral infarction w cc 2, % Simple pneumonia & pleurisy w cc 2, % Cellulitis w/o mcc 2, % Septicemia or severe sepsis w/o mv 96+ hours w/o mcc 2, % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 10

11 Top 10 ICD-9 Diagnoses for Home Health Episodes, California Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Diabetes mellitus 50, % Care involving use of rehabilitation procedures 33, % Other and unspecified aftercare 33, % Other orthopedic aftercare 32, % Chronic ulcer of skin 24, % Hypertensive heart disease 18, % Heart failure 18, % Essential hypertension 16, % Osteoarthrosis and allied disorders 14, % Late effects of cerebrovascular disease 13, % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

12 Top 10 MS-DRG Codes for Home Health Episodes, Colorado Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 2, % w/o mcc Septicemia or severe sepsis w/o mv 96+ hours w mcc % Hip & femur procedures except major joint w cc % Spinal fusion except cervical w/o mcc % Kidney & urinary tract infections w/o mcc % Intracranial hemorrhage or cerebral infarction w cc % Heart failure & shock w cc % Simple pneumonia & pleurisy w cc % Cellulitis w/o mcc % Renal failure w cc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 12

13 Top 10 ICD-9 Diagnoses for Home Health Episodes, Colorado Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Care involving use of rehabilitation procedures 8, % Other orthopedic aftercare 5, % Other and unspecified aftercare 3, % Diabetes mellitus 2, % Chronic ulcer of skin 2, % Heart failure 1, % Late effects of cerebrovascular disease 1, % Disorders of muscle, ligament, and fascia 1, % Chronic bronchitis 1, % Symptoms involving nervous and musculoskeletal systems % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

14 Top 10 MS-DRG Codes for Home Health Episodes, Connecticut Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 3, % w/o mcc Septicemia or severe sepsis w/o mv 96+ hours w mcc % Heart failure & shock w cc % Heart failure & shock w mcc % Kidney & urinary tract infections w/o mcc % Simple pneumonia & pleurisy w cc % Cellulitis w/o mcc % Simple pneumonia & pleurisy w mcc % Hip & femur procedures except major joint w cc % Renal failure w cc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 14

15 Top 10 ICD-9 Diagnoses for Home Health Episodes, Connecticut Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Other orthopedic aftercare 7, % Other and unspecified aftercare 7, % Heart failure 6, % Diabetes mellitus 6, % Care involving use of rehabilitation procedures 4, % Chronic ulcer of skin 3, % Essential hypertension 3, % Chronic bronchitis 3, % Other deficiency anemias 2, % Symptoms involving nervous and musculoskeletal systems 2, % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

16 Top 10 MS-DRG Codes for Home Health Episodes, Delaware Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity % w/o mcc Heart failure & shock w cc % Septicemia or severe sepsis w/o mv 96+ hours w mcc % Heart failure & shock w mcc % Simple pneumonia & pleurisy w mcc % Kidney & urinary tract infections w/o mcc % Intracranial hemorrhage or cerebral infarction w cc % Renal failure w cc % Simple pneumonia & pleurisy w cc % Chronic obstructive pulmonary disease w mcc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 16

17 Top 10 ICD-9 Diagnoses for Home Health Episodes, Delaware Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Other and unspecified aftercare 2, % Other orthopedic aftercare 1, % Care involving use of rehabilitation procedures 1, % Heart failure 1, % Diabetes mellitus % Chronic bronchitis % Chronic ulcer of skin % Late effects of cerebrovascular disease % Other complications of procedures, not elsewhere classified % Essential hypertension % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

18 Top 10 MS-DRG Codes for Home Health Episodes, District of Columbia Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity % w/o mcc Heart failure & shock w cc % Heart failure & shock w mcc % Renal failure w cc % Kidney & urinary tract infections w/o mcc % Intracranial hemorrhage or cerebral infarction w cc % Septicemia or severe sepsis w/o mv 96+ hours w mcc % Esophagitis, gastroent & misc digest disorders w/o mcc % Misc disorders of nutrition, metabolism,fluids/electrolytes w/o % mcc Cellulitis w/o mcc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 18

19 Top 10 ICD-9 Diagnoses for Home Health Episodes, District of Columbia Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Care involving use of rehabilitation procedures 1, % Diabetes mellitus % Other orthopedic aftercare % Heart failure % Chronic ulcer of skin % Other and unspecified aftercare % Late effects of cerebrovascular disease % Essential hypertension % Disorders of muscle, ligament, and fascia % General symptoms % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

20 Top 10 MS-DRG Codes for Home Health Episodes, Florida Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 15, % w/o mcc Septicemia or severe sepsis w/o mv 96+ hours w mcc 3, % Heart failure & shock w cc 3, % Kidney & urinary tract infections w/o mcc 2, % Hip & femur procedures except major joint w cc 2, % Heart failure & shock w mcc 2, % Cellulitis w/o mcc 2, % Chronic obstructive pulmonary disease w mcc 2, % Spinal fusion except cervical w/o mcc 2, % Renal failure w cc 2, % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 20

21 Top 10 ICD-9 Diagnoses for Home Health Episodes, Florida Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Care involving use of rehabilitation procedures 70, % Diabetes mellitus 61, % Other and unspecified aftercare 53, % Other orthopedic aftercare 41, % Heart failure 24, % Chronic ulcer of skin 23, % Essential hypertension 22, % Osteoarthrosis and allied disorders 21, % Symptoms involving nervous and musculoskeletal systems 17, % Other and unspecified disorders of back 17, % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

22 Top 10 MS-DRG Codes for Home Health Episodes, Georgia Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 4, % w/o mcc Septicemia or severe sepsis w/o mv 96+ hours w mcc 1, % Heart failure & shock w cc 1, % Hip & femur procedures except major joint w cc 1, % Heart failure & shock w mcc 1, % Intracranial hemorrhage or cerebral infarction w cc % Kidney & urinary tract infections w/o mcc % Renal failure w cc % Simple pneumonia & pleurisy w cc % Simple pneumonia & pleurisy w mcc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 22

23 Top 10 ICD-9 Diagnoses for Home Health Episodes, Georgia Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Care involving use of rehabilitation procedures 17, % Other orthopedic aftercare 11, % Diabetes mellitus 11, % Heart failure 10, % Chronic ulcer of skin 8, % Other and unspecified aftercare 8, % Essential hypertension 7, % Chronic bronchitis 5, % Late effects of cerebrovascular disease 5, % Other deficiency anemias 3, % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

24 Top 10 MS-DRG Codes for Home Health Episodes, Hawaii Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity % w/o mcc Septicemia or severe sepsis w/o mv 96+ hours w mcc % Intracranial hemorrhage or cerebral infarction w cc % Hip & femur procedures except major joint w cc % Septicemia or severe sepsis w/o mv 96+ hours w/o mcc % Heart failure & shock w cc % Respiratory infections & inflammations w cc % Simple pneumonia & pleurisy w cc % Simple pneumonia & pleurisy w mcc % Heart failure & shock w mcc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 24

25 Top 10 ICD-9 Diagnoses for Home Health Episodes, Hawaii Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Care involving use of rehabilitation procedures % Other orthopedic aftercare % Chronic ulcer of skin % Other and unspecified aftercare % Diabetes mellitus % Late effects of cerebrovascular disease % Heart failure % Other cellulitis and abscess % Pneumonia, organism unspecified % Fitting and adjustment of other device % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

26 Top 10 MS-DRG Codes for Home Health Episodes, Idaho Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity % w/o mcc Septicemia or severe sepsis w/o mv 96+ hours w mcc % Spinal fusion except cervical w/o mcc % Hip & femur procedures except major joint w cc % Septicemia or severe sepsis w/o mv 96+ hours w/o mcc % Heart failure & shock w mcc % Pulmonary edema & respiratory failure % Intracranial hemorrhage or cerebral infarction w cc % Heart failure & shock w cc % Simple pneumonia & pleurisy w mcc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 26

27 Top 10 ICD-9 Diagnoses for Home Health Episodes, Idaho Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Care involving use of rehabilitation procedures 2, % Other orthopedic aftercare 2, % Other and unspecified aftercare 1, % Disorders of muscle, ligament, and fascia 1, % Diabetes mellitus 1, % Chronic ulcer of skin % Heart failure % Late effects of cerebrovascular disease % Symptoms involving nervous and musculoskeletal systems % Fitting and adjustment of other device % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

28 Top 10 MS-DRG Codes for Home Health Episodes, Illinois Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 10, % w/o mcc Heart failure & shock w cc 2, % Septicemia or severe sepsis w/o mv 96+ hours w mcc 2, % Heart failure & shock w mcc 1, % Kidney & urinary tract infections w/o mcc 1, % Hip & femur procedures except major joint w cc 1, % Simple pneumonia & pleurisy w cc 1, % Intracranial hemorrhage or cerebral infarction w cc 1, % Cellulitis w/o mcc 1, % Renal failure w cc 1, % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 28

29 Top 10 ICD-9 Diagnoses for Home Health Episodes, Illinois Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Diabetes mellitus 46, % Osteoarthrosis and allied disorders 38, % Essential hypertension 30, % Heart failure 26, % Other orthopedic aftercare 24, % Other and unspecified aftercare 20, % Care involving use of rehabilitation procedures 16, % Hypertensive heart disease 14, % Chronic ulcer of skin 12, % Late effects of cerebrovascular disease 11, % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

30 Top 10 MS-DRG Codes for Home Health Episodes, Indiana Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 3, % w/o mcc Septicemia or severe sepsis w/o mv 96+ hours w mcc 1, % Heart failure & shock w cc % Heart failure & shock w mcc % Kidney & urinary tract infections w/o mcc % Renal failure w cc % Chronic obstructive pulmonary disease w mcc % Simple pneumonia & pleurisy w cc % Intracranial hemorrhage or cerebral infarction w cc % Cellulitis w/o mcc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 30

31 Top 10 ICD-9 Diagnoses for Home Health Episodes, Indiana Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Care involving use of rehabilitation procedures 11, % Heart failure 8, % Diabetes mellitus 8, % Other orthopedic aftercare 7, % Other and unspecified aftercare 6, % Chronic ulcer of skin 4, % Chronic bronchitis 3, % Late effects of cerebrovascular disease 3, % Disorders of muscle, ligament, and fascia 3, % Essential hypertension 3, % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

32 Top 10 MS-DRG Codes for Home Health Episodes, Iowa Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 1, % w/o mcc Septicemia or severe sepsis w/o mv 96+ hours w mcc % Heart failure & shock w cc % Hip & femur procedures except major joint w cc % Heart failure & shock w mcc % Simple pneumonia & pleurisy w cc % Simple pneumonia & pleurisy w mcc % Pulmonary edema & respiratory failure % Cellulitis w/o mcc % Intracranial hemorrhage or cerebral infarction w cc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 32

33 Top 10 ICD-9 Diagnoses for Home Health Episodes, Iowa Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Other orthopedic aftercare 4, % Other and unspecified aftercare 3, % Care involving use of rehabilitation procedures 3, % Heart failure 2, % Diabetes mellitus 1, % Chronic bronchitis 1, % Disorders of muscle, ligament, and fascia 1, % Chronic ulcer of skin % Late effects of cerebrovascular disease % Pneumonia, organism unspecified % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

34 Top 10 MS-DRG Codes for Home Health Episodes, Kansas Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 1, % w/o mcc Septicemia or severe sepsis w/o mv 96+ hours w mcc % Heart failure & shock w cc % Hip & femur procedures except major joint w cc % Heart failure & shock w mcc % Renal failure w cc % Simple pneumonia & pleurisy w cc % Cellulitis w/o mcc % Simple pneumonia & pleurisy w mcc % Kidney & urinary tract infections w/o mcc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 34

35 Top 10 ICD-9 Diagnoses for Home Health Episodes, Kansas Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Care involving use of rehabilitation procedures 3, % Other orthopedic aftercare 3, % Other and unspecified aftercare 3, % Diabetes mellitus 2, % Heart failure 2, % Chronic ulcer of skin 1, % Chronic bronchitis 1, % Late effects of cerebrovascular disease 1, % Essential hypertension % Fitting and adjustment of other device % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

36 Top 10 MS-DRG Codes for Home Health Episodes, Kentucky Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 3, % w/o mcc Heart failure & shock w cc % Septicemia or severe sepsis w/o mv 96+ hours w mcc % Heart failure & shock w mcc % Hip & femur procedures except major joint w cc % Simple pneumonia & pleurisy w cc % Simple pneumonia & pleurisy w mcc % Intracranial hemorrhage or cerebral infarction w cc % Kidney & urinary tract infections w/o mcc % Renal failure w cc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 36

37 Top 10 ICD-9 Diagnoses for Home Health Episodes, Kentucky Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Other orthopedic aftercare 9, % Care involving use of rehabilitation procedures 9, % Heart failure 7, % Other and unspecified aftercare 6, % Other deficiency anemias 6, % Diabetes mellitus 6, % Chronic ulcer of skin 5, % Chronic bronchitis 5, % Essential hypertension 4, % Late effects of cerebrovascular disease 3, % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

38 Top 10 MS-DRG Codes for Home Health Episodes, Louisiana Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 2, % w/o mcc Heart failure & shock w cc % Heart failure & shock w mcc % Intracranial hemorrhage or cerebral infarction w cc % Septicemia or severe sepsis w/o mv 96+ hours w mcc % Cellulitis w/o mcc % Hip & femur procedures except major joint w cc % Kidney & urinary tract infections w/o mcc % Simple pneumonia & pleurisy w cc % Renal failure w cc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 38

39 Top 10 ICD-9 Diagnoses for Home Health Episodes, Louisiana Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Diabetes mellitus 29, % Essential hypertension 22, % Heart failure 13, % Osteoarthrosis and allied disorders 9, % Hypertensive heart disease 8, % Chronic bronchitis 8, % Other orthopedic aftercare 7, % Cardiac dysrhythmias 6, % Other and unspecified arthropathies 6, % Other and unspecified aftercare 6, % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

40 Top 10 MS-DRG Codes for Home Health Episodes, Maine Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 1, % w/o mcc Septicemia or severe sepsis w/o mv 96+ hours w mcc % Heart failure & shock w cc % Hip & femur procedures except major joint w cc % Simple pneumonia & pleurisy w cc % Heart failure & shock w mcc % Simple pneumonia & pleurisy w mcc % Chronic obstructive pulmonary disease w mcc % Intracranial hemorrhage or cerebral infarction w cc % Kidney & urinary tract infections w/o mcc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 40

41 Top 10 ICD-9 Diagnoses for Home Health Episodes, Maine Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Care involving use of rehabilitation procedures 4, % Other orthopedic aftercare 3, % Other and unspecified aftercare 2, % Heart failure 1, % Chronic ulcer of skin 1, % Chronic bronchitis 1, % Diabetes mellitus % Fitting and adjustment of other device % Late effects of cerebrovascular disease % Other complications of procedures, not elsewhere classified % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

42 Top 10 MS-DRG Codes for Home Health Episodes, Maryland Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 4, % w/o mcc Rehabilitation w cc/mcc 1, % Heart failure & shock w cc 1, % Septicemia or severe sepsis w/o mv 96+ hours w mcc 1, % Kidney & urinary tract infections w/o mcc % Simple pneumonia & pleurisy w cc % Heart failure & shock w mcc % Cellulitis w/o mcc % Hip & femur procedures except major joint w cc % Renal failure w cc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 42

43 Top 10 ICD-9 Diagnoses for Home Health Episodes, Maryland Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Care involving use of rehabilitation procedures 14, % Other orthopedic aftercare 9, % Other and unspecified aftercare 7, % Heart failure 5, % Chronic ulcer of skin 4, % Diabetes mellitus 4, % Late effects of cerebrovascular disease 3, % Chronic bronchitis 2, % Disorders of muscle, ligament, and fascia 2, % Other complications of procedures, not elsewhere classified 2, % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

44 Top 10 MS-DRG Codes for Home Health Episodes, Massachusetts Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 7, % w/o mcc Heart failure & shock w cc 1, % Septicemia or severe sepsis w/o mv 96+ hours w mcc 1, % Heart failure & shock w mcc 1, % Kidney & urinary tract infections w/o mcc 1, % Simple pneumonia & pleurisy w cc 1, % Cellulitis w/o mcc 1, % Chronic obstructive pulmonary disease w mcc 1, % Renal failure w cc 1, % Chronic obstructive pulmonary disease w cc 1, % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 44

45 Top 10 ICD-9 Diagnoses for Home Health Episodes, Massachusetts Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Other orthopedic aftercare 18, % Other and unspecified aftercare 16, % Heart failure 12, % Care involving use of rehabilitation procedures 12, % Diabetes mellitus 10, % Chronic ulcer of skin 6, % Chronic bronchitis 6, % Cardiac dysrhythmias 4, % Essential hypertension 4, % Other deficiency anemias 4, % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

46 Top 10 MS-DRG Codes for Home Health Episodes, Michigan Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 7, % w/o mcc Septicemia or severe sepsis w/o mv 96+ hours w mcc 3, % Heart failure & shock w cc 1, % Heart failure & shock w mcc 1, % Cellulitis w/o mcc 1, % Chronic obstructive pulmonary disease w mcc 1, % Renal failure w cc 1, % Kidney & urinary tract infections w/o mcc 1, % Chronic obstructive pulmonary disease w cc 1, % Intracranial hemorrhage or cerebral infarction w cc 1, % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 46

47 Top 10 ICD-9 Diagnoses for Home Health Episodes, Michigan Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Care involving use of rehabilitation procedures 25, % Diabetes mellitus 19, % Other orthopedic aftercare 18, % Other and unspecified aftercare 17, % Heart failure 16, % Essential hypertension 11, % Osteoarthrosis and allied disorders 10, % Chronic ulcer of skin 9, % Late effects of cerebrovascular disease 8, % Chronic bronchitis 7, % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

48 Top 10 MS-DRG Codes for Home Health Episodes, Minnesota Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 2, % w/o mcc Septicemia or severe sepsis w/o mv 96+ hours w mcc % Hip & femur procedures except major joint w cc % Heart failure & shock w cc % Heart failure & shock w mcc % Intracranial hemorrhage or cerebral infarction w cc % Simple pneumonia & pleurisy w cc % Cellulitis w/o mcc % Kidney & urinary tract infections w/o mcc % Septicemia or severe sepsis w/o mv 96+ hours w/o mcc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 48

49 Top 10 ICD-9 Diagnoses for Home Health Episodes, Minnesota Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Care involving use of rehabilitation procedures 9, % Other orthopedic aftercare 5, % Other and unspecified aftercare 3, % Heart failure 2, % Diabetes mellitus 1, % Chronic ulcer of skin 1, % Late effects of cerebrovascular disease 1, % Chronic bronchitis % Fitting and adjustment of other device % General symptoms % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

50 Top 10 MS-DRG Codes for Home Health Episodes, Mississippi Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 2, % w/o mcc Heart failure & shock w cc % Intracranial hemorrhage or cerebral infarction w cc % Septicemia or severe sepsis w/o mv 96+ hours w mcc % Heart failure & shock w mcc % Kidney & urinary tract infections w/o mcc % Simple pneumonia & pleurisy w cc % Hip & femur procedures except major joint w cc % Esophagitis, gastroent & misc digest disorders w/o mcc % Renal failure w cc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 50

51 Top 10 ICD-9 Diagnoses for Home Health Episodes, Mississippi Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Diabetes mellitus 16, % Essential hypertension 16, % Heart failure 11, % Osteoarthrosis and allied disorders 7, % Other orthopedic aftercare 6, % Chronic bronchitis 6, % Chronic ulcer of skin 5, % Other and unspecified aftercare 5, % Care involving use of rehabilitation procedures 5, % Late effects of cerebrovascular disease 4, % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

52 Top 10 MS-DRG Codes for Home Health Episodes, Missouri Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 5, % w/o mcc Septicemia or severe sepsis w/o mv 96+ hours w mcc 1, % Heart failure & shock w mcc % Heart failure & shock w cc % Hip & femur procedures except major joint w cc % Simple pneumonia & pleurisy w mcc % Intracranial hemorrhage or cerebral infarction w cc % Simple pneumonia & pleurisy w cc % Renal failure w cc % Cellulitis w/o mcc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 52

53 Top 10 ICD-9 Diagnoses for Home Health Episodes, Missouri Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Other orthopedic aftercare 13, % Care involving use of rehabilitation procedures 9, % Other and unspecified aftercare 9, % Diabetes mellitus 6, % Heart failure 5, % Chronic ulcer of skin 4, % Chronic bronchitis 3, % Late effects of cerebrovascular disease 3, % Essential hypertension 2, % Other complications of procedures, not elsewhere classified 2, % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

54 Top 10 MS-DRG Codes for Home Health Episodes, Montana Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity % w/o mcc Septicemia or severe sepsis w/o mv 96+ hours w mcc % Hip & femur procedures except major joint w cc % Intracranial hemorrhage or cerebral infarction w cc % Heart failure & shock w mcc % Heart failure & shock w cc % Cellulitis w/o mcc % Simple pneumonia & pleurisy w mcc % Simple pneumonia & pleurisy w cc % Kidney & urinary tract infections w/o mcc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 54

55 Top 10 ICD-9 Diagnoses for Home Health Episodes, Montana Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Care involving use of rehabilitation procedures 1, % Other orthopedic aftercare 1, % Other and unspecified aftercare % Heart failure % Chronic ulcer of skin % Fitting and adjustment of other device % Late effects of cerebrovascular disease % Chronic bronchitis % General symptoms % Diabetes mellitus % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

56 Top 10 MS-DRG Codes for Home Health Episodes, Nebraska Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 1, % w/o mcc Hip & femur procedures except major joint w cc % Heart failure & shock w cc % Simple pneumonia & pleurisy w cc % Septicemia or severe sepsis w/o mv 96+ hours w mcc % Kidney & urinary tract infections w/o mcc % Cellulitis w/o mcc % Chronic obstructive pulmonary disease w mcc % Intracranial hemorrhage or cerebral infarction w cc % Chronic obstructive pulmonary disease w cc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 56

57 Top 10 ICD-9 Diagnoses for Home Health Episodes, Nebraska Top 10 Most Common Primary International Classification of Diseases, Version 9 (ICD-9) Diagnoses for all Home Health Episodes, 2012 ICD-9 Diagnosis Claims, 2012 Health Claims, 2012 Care involving use of rehabilitation procedures 3, % Other orthopedic aftercare 2, % Other and unspecified aftercare 2, % Heart failure 1, % Diabetes mellitus 1, % Chronic ulcer of skin % Chronic bronchitis % Late effects of cerebrovascular disease % Disorders of muscle, ligament, and fascia % Fitting and adjustment of other device % Source: Avalere analysis of the 100% Medicare Standard Analytic Files,

58 Top 10 MS-DRG Codes for Home Health Episodes, Nevada Top 10 Most Common Diagnoses Related Groups (MS-DRGs) for Beneficiaries Discharged from Hospital to Part A Home Health Episodes, 2012 MS-DRG Part A Claims, 2012 Health Part A Claims, 2012 Major joint replacement or reattachment of lower extremity 1, % w/o mcc Septicemia or severe sepsis w/o mv 96+ hours w mcc % Intracranial hemorrhage or cerebral infarction w cc % Hip & femur procedures except major joint w cc % Kidney & urinary tract infections w/o mcc % Renal failure w cc % Heart failure & shock w cc % % Simple pneumonia & pleurisy w mcc % Spinal fusion except cervical w/o mcc % Source: Avalere Health, LLC analysis of Medicare Standard Analytic Files, 2012 Data for beneficiaries with a Part A home health episode and a prior short-term acute care hospital stay in Note: CC is complication or comorbidity. MCC is major complication or comorbidity. 58

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