**Agency for Healthcare Research and Quality**

**Inpatient Quality Indicators (IQIs)**

**Updates to Version 2.1 -- ICD-9-CM Coding Updates**

**September 4, 2003**

The following changes were implemented in version 2.1, revision 2, of
the IQI software (both SAS and SPSS) and reflect changes to indicator
definitions based on updates to ICD-9-CM codes for Fiscal Year 2002
(effective 10-1-2001) and Fiscal Year 2003 (effective 10-1-2002). All
changes noted below have been incorporated into the software syntax,
software documentation and the Guide to Inpatient Quality Indicators.
With this software update, the IQI software definitions now incorporate
ICD-9 CM codes valid from October 1, 1994 through September 30, 2003.

+-------+-------------+-------------+--------------------------------+
| **    | *           | ***C        | ***Change***                   |
| *Indi | **Indicator | omponent*** |                                |
| cator | Name (#)*** |             |                                |
| Modu  |             |             |                                |
| le*** |             |             |                                |
+=======+=============+=============+================================+
| IQI   | Pediatric   | Numerator   | The new code (FY 2003) 747.83, |
|       | Heart       | (congenital | "Persistent fetal circulation" |
|       | Surgery     | heart       | was added to the definition of |
|       | Volume (IQI | defect, 3D) | congenital heart defect (3D).  |
|       | 3)          |             |                                |
+-------+-------------+-------------+--------------------------------+
|       |             | Numerator   | The new code (FY 2003) 36.07,  |
|       |             |             | "Insertion of drug-eluting     |
|       |             | (Pediatric  | coronary artery stent(s) /     |
|       |             | heart       | endograft(s) was added to the  |
|       |             | surgery,    | including definition of        |
|       |             | #2P)        | pediatric heart surgery (#2P). |
+-------+-------------+-------------+--------------------------------+
|       |             | Numerator   | The new code (FY 2003) 37.28   |
|       |             |             | Intracardiac echocardiography  |
|       |             | (Pediatric  | ICE was added to the including |
|       |             | heart       | definition of pediatric heart  |
|       |             | surgery,    | surgery (#2P).                 |
|       |             | #2P)        |                                |
+-------+-------------+-------------+--------------------------------+
|       |             | Numerator   | The new codes (FY 2003) 00.50  |
|       |             |             | -- 00.54, "implantation or     |
|       |             | (Pediatric  | replacement of transvenous     |
|       |             | heart       | lead" was added to the         |
|       |             | surgery,    | including definition of        |
|       |             | #2P)        | pediatric heart surgery (#2P). |
+-------+-------------+-------------+--------------------------------+
| IQI   | Pediatric   | Denominator | The new code (FY 2003) 747.83, |
|       | Heart       | (congenital | "Persistent fetal circulation" |
|       | Surgery     | heart       | was added to the denominator   |
|       | Mortality   | defect, 3D) | exclusion definition of        |
|       | (IQI 10)    |             | congenital heart defect (3D).  |
+-------+-------------+-------------+--------------------------------+
|       |             | Denominator | The new code (FY 2003) 36.07,  |
|       |             |             | "Insertion of drug-eluting     |
|       |             | (Pediatric  | coronary artery stent(s) /     |
|       |             | heart       | endograft(s) was added to the  |
|       |             | surgery,    | including definition of        |
|       |             | #2P)        | pediatric heart surgery (#2P). |
+-------+-------------+-------------+--------------------------------+
|       |             | Denominator | The new code (FY 2003) 37.28   |
|       |             |             | Intracardiac echocardiography  |
|       |             | (Pediatric  | ICE was added to the including |
|       |             | heart       | definition of pediatric heart  |
|       |             | surgery,    | surgery (#2P).                 |
|       |             | #2P)        |                                |
+-------+-------------+-------------+--------------------------------+
|       |             | Denominator | The new codes (FY 2003) 00.50  |
|       |             |             | -- 00.54, "implantation or     |
|       |             | (Pediatric  | replacement of transvenous     |
|       |             | heart       | lead" was added to the         |
|       |             | surgery,    | including definition of        |
|       |             | #2P)        | pediatric heart surgery (#2P). |
+-------+-------------+-------------+--------------------------------+
| IQI   | CHF         | Denominator | The new codes (FY 2003),       |
|       | Mortality   | (Congestive | 428.20-3, "Systolic heart      |
|       | Rate (IQI   | heart       | failure," 428.30-3, "Diastolic |
|       | 16)         | failure)    | heart failure," and 428.40-3,  |
|       |             |             | "Combined systolic and         |
|       |             |             | diastolic heart failure" were  |
|       |             |             | added to the including         |
|       |             |             | definition of congestive heart |
|       |             |             | failure.                       |
+-------+-------------+-------------+--------------------------------+
| IQI   | GI          | Denominator | The new codes (FY 2003),       |
|       | Hemorrhage  | (Gastr      | 537.84, "Dieulafoy lesion      |
|       | Mortality   | ointestinal | (hemorrhagic) of stomach and   |
|       | Rate (IQI   | hemorrhage) | duodenum" and 569.86,          |
|       | 18)         |             | "Dieulafoy lesion              |
|       |             |             | (hemorrhagic) of intestine"    |
|       |             |             | were added to the including    |
|       |             |             | definition of gastrointestinal |
|       |             |             | hemorrhage.                    |
+-------+-------------+-------------+--------------------------------+
| IQI   | Bilateral   | Denominator | New code (FY 2003) 747.83,     |
|       | Heart       | (exclusion, | "Persistent fetal circulation" |
|       | Cath        | valid       | was added to the               |
|       | eterization | i           | denominator-exclusion for      |
|       | Rate (IQI   | ndications) | bilateral heart                |
|       | 25)         |             | catheterization rate.          |
+-------+-------------+-------------+--------------------------------+
|       |             | Denominator | New subcodes (FY 2003),        |
|       |             |             | 414.06, "Coronary              |
|       |             |             | atherosclerosis of coronary    |
|       |             |             | artery of transplanted heart"  |
|       |             |             | and 414.12, "Dissection of     |
|       |             |             | coronary artery," were added   |
|       |             |             | to the denominator definition  |
|       |             |             | of Bilateral Heart             |
|       |             |             | Catheterization Rate.          |
+-------+-------------+-------------+--------------------------------+
| IQI   | Laminectomy | Numerator   | All codes in the new category  |
|       | Area Rate   | (           | (FY 2002), 81.3, "Refusion of  |
|       | (IQI 29)    | laminectomy | spine" was added to the        |
|       |             | and/or      | numerator definition of        |
|       |             | spinal      | laminectomy and/or spinal      |
|       |             | fusion)     | fusion.                        |
+-------+-------------+-------------+--------------------------------+
|       |             | Numerator   | New code (FY 2003) 81.61, "360 |
|       |             | (           | degree spinal fusion, single   |
|       |             | laminectomy | incision approach" was added   |
|       |             | and/or      | to the numerator definition of |
|       |             | spinal      | laminectomy and/or spinal      |
|       |             | fusion)     | fusion.                        |
+-------+-------------+-------------+--------------------------------+
|       |             | Numerator   | New code (FY 2003) 84.51,      |
|       |             | (           | "insertion of interbody spinal |
|       |             | laminectomy | fusion device," was added to   |
|       |             | and/or      | the numerator definition of    |
|       |             | spinal      | laminectomy and/or spinal      |
|       |             | fusion)     | fusion.                        |
+-------+-------------+-------------+--------------------------------+