Muhammad Khan (mkhan@oxhp.com) asks:

>Hi Everyone, > I have a list of relative cost factors that I need to apply to ICD9 >codes (ICD1, ICD2 and ICD3 ). Here is the problem. I pulled all the ICD9 >codes, now I want to apply the highest Cost factor to the ICD9 code.

>Example:

>If a member has an ICD1 code 011 the relative factor for this code is 26.39, >now if the same member has the ICD2 141 the relative factor is 41.92 and if >the ICD3 is 042 the factor becomes 60.97. I need to apply the highest >factor to this member, in this case 60.97 regardless of ICD1, ICD2 or ICD3. >I have more than 100 ICD9 codes and relative factors associated with it. >Also, there are some ICD codes that are listed as 011, but I need to apply >the factors to all the codes that falls into 011 code range, such as 011.01, >011.02, 011.03 e.t.c. I would appreciate any help on getting me started on >this problem. >TIA > Muhammed:

Given the elusive nature of ICD9 codes, I think your best bet for handling this problem is to look into building a BIG FORMAT to do the matching. You can search on the list archives for some tips on BIG FORMATS. You will save yourself some heartache if you define your ICD9's as character rather than numeric. As you have seen, ICD9 can be three characters (011) or three characters plus detail (011.02, 01.03). An additional problem is that those detail codes are not necessarily contiguous. For example, my recollecction is that the codes for mental illness interleave neurosis and psychosis, which probably have different cost factors.

Dianne Louise Rhodes Sr. Systems Analyst Westat (formerly at the US Dept of Labor, Office of Workers Compensation) (301) 315-5977 work (301) 315-5934 fax

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