**Agency for Healthcare Research and Quality: Prevention Quality
Indicators (PQIs)**

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

**January 9, 2004**

The following changes were implemented in version 2.1, revision 3, of
the PQI software, both SAS and SPSS, and reflect changes to indicator
definitions based on updates to ICD-9-CM codes for Fiscal Year 2003
(effective 10-1-2002) and Fiscal Year 2004 (effective 10-1-2003). All
changes noted below have been incorporated into the software syntax,
software documentation and the Guide to Prevention Quality Indicators.

+-------+-------------+-------------+--------------------------------+
| **    | *           | ***C        | ***Change***                   |
| *Indi | **Indicator | omponent*** |                                |
| cator | Name (#)*** |             |                                |
| Modu  |             |             |                                |
| le*** |             |             |                                |
+=======+=============+=============+================================+
| PQI   | Bacterial   | Numerator   | New codes (FY 2004) 282.41,    |
|       | Pneumonia   | (exclusion, | 282.42, 282.64, 282.68 were    |
|       | Admission   | sickle cell | added to the numerator         |
|       | Rate (PQI   | anemia and  | exclusion definition of HB-S   |
|       | #11)        | HB-S        | and sickle cell anemia. This   |
|       |             | disease)    | change may result in a         |
|       |             |             | comparability issue with       |
|       |             |             | previous years since 282.4 was |
|       |             |             | not previously included in the |
|       |             |             | sickle cell definition.        |
+-------+-------------+-------------+--------------------------------+
| PQI   | Adult       | Numerator   | New codes (FY 2004), 493.81    |
|       | Asthma      | (Asthma)    | "Exercised Induced             |
|       | Admission   |             | Bronchospasm" and 493.82       |
|       | Rate (PQI   |             | "Cough Variant Asthma" were    |
|       | #15) and    |             | added to the numerator         |
|       | Pediatric   |             | definition of asthma           |
|       | Asthma      |             |                                |
|       | Admission   |             |                                |
|       | Rate (PQI   |             |                                |
|       | #4)         |             |                                |
+-------+-------------+-------------+--------------------------------+
| PQI   | Congestive  | Numerator   | The new codes (FY 2003),       |
|       | Heart       | (CHF)       | 428.20-3, "Systolic heart      |
|       | Failure     |             | failure," 428.30-3, "Diastolic |
|       | (CHF)       |             | heart failure," and 428.40-3,  |
|       | Admission   |             | "Combined systolic and         |
|       | Rate        |             | diastolic heart failure" were  |
|       |             |             | added to the including         |
|       | (PQI #8)    |             | definition of congestive heart |
|       |             |             | failure.                       |
+-------+-------------+-------------+--------------------------------+
|       |             | Numerator   | The new code (FY 2003), 36.07, |
|       |             | (exclusion, | "Insertion of drug-eluting     |
|       |             | cardiac     | coronary artery stent(s)       |
|       |             | procedures) | Endograft(s), Endovascular     |
|       |             |             | graft(s), Stent graft(s)" was  |
|       |             |             | added to the exclusion         |
|       |             |             | definition of cardiac          |
|       |             |             | procedures.                    |
+-------+-------------+-------------+--------------------------------+
|       |             | Numerator   | The new codes (FY 2003),       |
|       |             | (exclusion, | 00.50-00.54, "implantation or  |
|       |             | cardiac     | replacement of transvenous     |
|       |             | procedures) | lead" were added to the        |
|       |             |             | exclusion definition of        |
|       |             |             | cardiac procedures.            |
+-------+-------------+-------------+--------------------------------+
|       |             | Numerator   | All new codes (FY 2004) in the |
|       |             | (exclusion, | new category heart replacement |
|       |             | cardiac     | procedures (37.5), including   |
|       |             | procedures) | 37.51, "heart                  |
|       |             |             | transplantation," 37.52        |
|       |             |             | "implantation of total         |
|       |             |             | replacement heart system,"     |
|       |             |             | 37.53 "replacement or repair   |
|       |             |             | of thoracic unit of total      |
|       |             |             | replacement heart system," and |
|       |             |             | 37.54 "replacement or repair   |
|       |             |             | of other implantable component |
|       |             |             | of total replacement heart     |
|       |             |             | system" were added to the      |
|       |             |             | numerator exclusion definition |
|       |             |             | of cardiac procedure. Note     |
|       |             |             | that 37.5, previously used for |
|       |             |             | heart transplantation          |
|       |             |             | procedure is invalid as of     |
|       |             |             | October 2003. This code was    |
|       |             |             | retained in the software for   |
|       |             |             | backward comparability.        |
+-------+-------------+-------------+--------------------------------+
| PQI   | H           | Numerator   | The new code (FY 2003), 36.07, |
|       | ypertension | (exclusion, | "Insertion of drug-eluting     |
|       | Admission   | cardiac     | coronary artery stent(s)       |
|       | Rate        | procedures) | Endograft(s), Endovascular     |
|       |             |             | graft(s), Stent graft(s)" was  |
|       | (PQI #7)    |             | added to the exclusion         |
|       |             |             | definition of cardiac          |
|       |             |             | procedures.                    |
+-------+-------------+-------------+--------------------------------+
|       |             | Numerator   | The new codes (FY 2003),       |
|       |             | (exclusion, | 00.50-00.54, "implantation or  |
|       |             | cardiac     | replacement of transvenous     |
|       |             | procedures) | lead" were added to the        |
|       |             |             | exclusion definition of        |
|       |             |             | cardiac procedures.            |
+-------+-------------+-------------+--------------------------------+
|       |             | Numerator   | All new codes (FY 2004) in the |
|       |             | (exclusion, | new category heart replacement |
|       |             | cardiac     | procedures (37.5), including   |
|       |             | procedures) | 37.51, "heart                  |
|       |             |             | transplantation," 37.52        |
|       |             |             | "implantation of total         |
|       |             |             | replacement heart system,"     |
|       |             |             | 37.53 "replacement or repair   |
|       |             |             | of thoracic unit of total      |
|       |             |             | replacement heart system," and |
|       |             |             | 37.54 "replacement or repair   |
|       |             |             | of other implantable component |
|       |             |             | of total replacement heart     |
|       |             |             | system" were added to the      |
|       |             |             | numerator exclusion definition |
|       |             |             | of cardiac procedure. Note     |
|       |             |             | that 37.5, previously used for |
|       |             |             | heart transplantation          |
|       |             |             | procedure is invalid as of     |
|       |             |             | October 2003. This code was    |
|       |             |             | retained in the software for   |
|       |             |             | backward comparability.        |
+-------+-------------+-------------+--------------------------------+
| PQI   | Angina      | Numerator   | The new code (FY 2003), 36.07, |
|       | Admission   | (exclusion, | "Insertion of drug-eluting     |
|       | Rate        | cardiac     | coronary artery stent(s)       |
|       |             | procedures) | Endograft(s), Endovascular     |
|       | (PQI #13)   |             | graft(s), Stent graft(s)" was  |
|       |             |             | added to the exclusion         |
|       |             |             | definition of cardiac          |
|       |             |             | procedures.                    |
+-------+-------------+-------------+--------------------------------+
|       |             | Numerator   | The new codes (FY 2003),       |
|       |             | (exclusion, | 00.50-00.54, "implantation or  |
|       |             | cardiac     | replacement of transvenous     |
|       |             | procedures) | lead" were added to the        |
|       |             |             | exclusion definition of        |
|       |             |             | cardiac procedures.            |
+-------+-------------+-------------+--------------------------------+
|       |             | Numerator   | All new codes (FY 2004) in the |
|       |             | (exclusion, | new category heart replacement |
|       |             | cardiac     | procedures (37.5), including   |
|       |             | procedures) | 37.51, "heart                  |
|       |             |             | transplantation," 37.52        |
|       |             |             | "implantation of total         |
|       |             |             | replacement heart system,"     |
|       |             |             | 37.53 "replacement or repair   |
|       |             |             | of thoracic unit of total      |
|       |             |             | replacement heart system," and |
|       |             |             | 37.54 "replacement or repair   |
|       |             |             | of other implantable component |
|       |             |             | of total replacement heart     |
|       |             |             | system" were added to the      |
|       |             |             | numerator exclusion definition |
|       |             |             | of cardiac procedure. Note     |
|       |             |             | that 37.5, previously used for |
|       |             |             | heart transplantation          |
|       |             |             | procedure is invalid as of     |
|       |             |             | October 2003. This code was    |
|       |             |             | retained in the software for   |
|       |             |             | backward comparability.        |
+-------+-------------+-------------+--------------------------------+