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HSCRC - PPR Case Data Field Names and Descriptions
Field Name / Description and ValuesRECID / Generated by 3M
MEDREC / From Provider
UNIQUEID / Generated by 3M
PROVIDER / Provider Number
SEX / Sex
DISCHSTAT / Discharge Status
01 - Home, self-care (Routine)
02 - Short term hospital
03 - Skilled Nursing Facility (SNF)
04 - Custodial/Supportive Care
05 - Cancer Center or Children's Hospital
06 - Home Health Service
07 - Left Against Medical Advice
20 - Expired
21 - Court/Law ENFRC
30 - Still a patient
40 - Expired at home (mapped to discharge status 20)
41 - Expired in a Medical Facility (mapped to discharge status 20)
42 - Expired- Place unknown (mapped to discharge status 20)
43 - Federal Hospital
50 - Hospice - home
51 - Hospice - medical facility
61 - Swing Bed
62 - Rehab facility/Rehab unit
63 - Long term care hospital
64 - Nursing facility - Medicaid certified
65 - Psych hosp/unit
66 - Critical Access Hospital
70 - Other institution
LOS / Length of Stay
TOTCHRG / Total Charges
DIAG1 / Principal Diagnosis
PPRVER / PPR version used. 270 - PPR v. 27.0
PPRERR / PPR Error Code
01 - APR grouping error
09 - Admissions after a patient has expired
10 - Mismatched birth date
11 - Mismatched sex
12 - Dates out of order
13 - Mismatched DtoA
14 - Patient ID cannot be blank
15 - Birth date parse error
16 - Admit date parse error
17 - Discharge date parse error
18 - Invalid hospital type
19 - Invalid readmission interval
20 - Invalid hospital exclusion type
21 - Invalid max admissions number
22 - Invalid max chains number
23 - Invalid max admissions per chain number
24 - Invalid outlier chains threshold number
25 - Invalid outlier admissions number
26 - Invalid across hospital value
27 - Invalid NE discharge status list
30 - Invalid occurrence number
31 - Duplicate occurrence number
32 - Invalid chain number
40 - Exceeded max admissions
41 - Exceeded max chains
42 - Exceeded max admissions per chain
50 - Record not initialized
51 - Invalid/mismatched PPR version
52 - Cannot open tables
53 - Incomplete or corrupted PPR version table
54 - Incompatible/mismatched APR grouper version
80 - Not enough memory to perform above operation
81 - Invalid data type
82 - Invalid POA value
83 - Error opening mapper table
84 - Error opening grouper table
86 - Unknown error
99 - Patient admission excluded due to an error in another admission
ADJAPRDRG / PPR Adjusted APR Diagnostic Related Group (DRG) for the record.
The PPR logic, defined in the Definitions manual, returns a PPR-adjusted APR DRG which is used to determined PPRs.
ADJAPRMDC / PPR Adjusted Major Diagnostic Category (MDC) for the record.
PPRTYPE / Record type is the result for a single record of the PPR logic. A record can only have one record type value.
MM - Major/metastatic malignancy admission
MA - Malignancy admission
TB - Trauma and burn admission
NT - Neonatal admission
OB - Obstetrical admission
OG - Other globally excluded APR-DRGs
LA - Left against medical advice admission
TA - Transfer admission
NE - Non-event admission
TR - Other trauma admission-Alive
TD - Other trauma admission-Died
IA - Initial admission
IR - Initial admission-trauma
RA - Readmission
RT - Readmission-transfer
OD - Only admission-died
OA - Only admission-alive
EE - Error DRG
PPRDPA / Days post admission (DPA), is a calculation between current admission date in the record and the discharge date of the previous eligible admission. Used in evaluating the admission against the user preference for readmission interval.
CLINREL / Indicates whether this admission was clinically related.
0 - Not applicable: meaning this admission was ruled out as a candidate for the PPR valid readmission matrix for one of the following reasons:
- hospital type exclusion
- globally excluded record type (LA, MM, MA, etc)
- left against medical advice
- NE
- first admission
- previous admission ended chain (except for other trauma, they should be a 1 below)
- days between prior and current admission greater than DtoA
- invalid patient data
1 - Not clinically related: eligible to be evaluated by the readmission matrix, but failed one of the following tests:
- Not in valid readmission matrix
- Mechanical device not in same MDC
- Had an other trauma PDX and was not globally excluded
2 - Clinically related: was an RA or RT
ADJPPRDRG / PPR Adjusted APR Diagnostic Related Group (DRG) for the chain.
The PPR logic, defined in the Definitions manual, returns a PPR-adjusted APR DRG which is used to determined PPRs.
ADJPPRMDC / PPR Adjusted Major Diagnostic Category (MDC) for the chain.
PPRAGE / This is an age range that is used for stratifing a population, it identifies the age range of a patient at the chain level.
Age at admission for the chain:
A - 0 to 7 days
B - 8 to 28 days
C - 29 to 365 days
D - 1 to 4 years
E - 5 to 17 years
F - 18 to 44 years
G - 45 to 64 years
H - 65 to 74 years
I - 75 to 84 years
J - 85+ yrs
PPRMHS / Mental Health Flag. Used to identify patients that have mental health diagnoses that indicate a higher probability of readmission over and above the already existing APR-DRG risk adjustment.
9 - Mental Health status not computed
0 - No Mental Health Issue
3 - Major Mental Health Issue
EXCLTYPE / Exclusion Type. Reason for the admission not being considered a PPR.
0 - not excluded
1 - hospital type exclusion
2 - record type (LA, MM, MA, etc.)
3 - not in chain and no further admissions
4 - days between discharge and next admission greater than DtoA
5 - next admission excluded
6 - not in valid APR DRG readmission matrix
7 - malfunction PDX with different MDC
8 - DRG age exclusion
CHAINNO / The chain number that the admission is associated with.
CHAINADM / Number of admissions in the chain.
CHAINEND / Reason for the chain ending.
0 - not in a chain
1 - end of admissions
2 - days between discharge and next admission greater than DtoA
3 - next admission previously excluded due to record type
4 - readmission transfer
5 - next admission not in valid APR DRG readmission matrix
6 - next admission malfunction PDX with different MDC
7 - DRG age exclusion
UCHAINNO / This specifies the unique chain number for each chain across dataset.
POS_CHAIN / This specifies the relative position of an admission within its chain.
DISAPRDRG / Discharge APR Diagnostic Related Group (DRG) for the record used for Risk Adjustment.
DISAPRMDC / Discharge Major Diagnostic Category (MDC) for the record for Risk Adjustment.
DiISAPRSOI / Discharge Severity of Illness (SOI) for the record for Risk Adjustment.
DISPPRDRG / Discharge APR Diagnostic Related Group (DRG) for the chain.
DISPPRMDC / Discharge Major Diagnostic Category (MDC) for the chain.
DISPPRSOI / Discharge Severity of Illness (SOI) for the chain.
REASONS / Indicates the reason why the admission was clinically related to the initial admission.
Valid values effective starting with PPR v27.0:
1 - Medical readmission for a continuation or recurrence of the reason for the initial admission, or for a closely related condition.
2a - Ambulatory care sensitive conditions as designated by ARHQ
2b - All other readmissions for a chronic problem that may be related to care either during or after the initial admission
3 - Medical readmission for an acute medical condition or complication that may be related to or may have resulted from care during the initial admission or in the post-discharge period after the initial admission.
4 - Readmission for a surgical procedure to address a continuation or a recurrence of the problem causing the initial admission.
5 - Readmission for surgical procedure to address a complication that may be related to or may have resulted from care during the initial admission.
6a - Readmission for mental health reasons following an initial admission for a non-mental health, non-substance abuse reason.
6b - Readmission for a substance abuse diagnosis reason following an initial admission for a non-mental health, non-substance abuse reason.
6c - Mental health or substance abuse readmission following an initial admission for a substance abuse or mental health diagnosis.