Flags Flag Description Rule Output Identifies delivery on mother's Z37 in first three characters of any zflag record diagnosis code Y Identifies birth or neonatal care Z38 in first three characters of any bflag on the baby's record diagnosis code and zflag not = Y Y Identifies complications of O47 or O60-O75 in first three oflag delivery characters of any diagnosis code Y Identifies postnatal care on Z39 in first three characters of any pflag mother's record diagnosis code Y Refer to Appendix 4 for the Primary Maternity RVUs Relative Value Unit (RVU) Flow Diagram for Primary Maternity Transplants (T0103, T0106, T0111, T0113) Some organ transplants are not purchased via casemix, namely liver, heart and lung transplants. In what follows, age means age at admission. The AR-DRGs A01Z Liver Transplant, A03Z Lung or Heart/Lung Transplant, and A05Z Heart Transplant are excluded from casemix funding and non-casemix purchase units allocated as follows: A01Z at Starship (facility code 3260 and age <16) has Excluded Purchase patient’s Unit (XPU) T0113 Liver Transplant Children A01Z not at Starship (facility code not 3260 OR age >15) has XPU T0111 patient’s Liver Transplant Adult A05Z has XPU T0103 Heart Transplant A03Z has XPU T0106 Lung Transplant. Note that simultaneous pancreas and kidney transplants are included in casemix funding, and are identified as those cases assigned to AR-DRG A09A Renal Transplant With Pancreas Transplant or With Catastrophic CC where the event includes a procedure code of 9032400 [981] Transplantation of pancreas. Spinal Injuries (S50001, S50002) Some Spinal Services are excluded as they are not purchased via casemix. Excluded Spinal Services are those with the Health Speciality Code S50 Spinal Surgery. Events where the admission type is WN (Waiting List) map to S50002 Spinal Services non-acute, and all other admission types map to S50001 Spinal Services acute cases. Surgical Termination of Pregnancy 2nd Trimester (S30009) 14 to 25 – – completed weeks Non-acute Surgical Termination of Pregnancy (ToP) events are excluded. These are tested for by checking that:
Flags Flag Description Rule Output zflag Identifies delivery on mother's record Z37 in first three characters of any diagnosis code Y bflag Identifies birth or neonatal care on the baby's record Z38 in first three characters of any diagnosis code and zflag not = Y Y oflag Identifies complications of delivery O47 or O60-O75 in first three characters of any diagnosis code Y pflag Identifies postnatal care on mother's record Z39 in first three characters of any diagnosis code Y Refer to Appendix 4 for the Primary Maternity RVUs Relative Value Unit (RVU) Flow Diagram for Primary Maternity Transplants (T0103, T0106, T0111, T0113) Some organ transplants are not purchased via casemix, namely liver, heart and lung transplants. In what follows, age means age at admission. The AR-DRGs A01Z Liver Transplant, A03Z Lung or Heart/Lung Transplant, and A05Z Heart Transplant are excluded from casemix funding and non-casemix purchase units allocated as follows: A01Z at Starship (facility code 3260 and patient’s age <16) has Excluded Purchase Unit (XPU) T0113 Liver Transplant Children A01Z not at Starship (facility code not 3260 OR patient’s age >15) has XPU T0111 Liver Transplant Adult A05Z has XPU T0103 Heart Transplant A03Z has XPU T0106 Lung Transplant. Note that simultaneous pancreas and kidney transplants are included in casemix funding, and are identified as those cases assigned to AR-DRG A09A Renal Transplant With Pancreas Transplant or With Catastrophic CC where the event includes a procedure code of 9032400 [981] Transplantation of pancreas. Spinal Injuries (S50001, S50002) Some Spinal Services are excluded as they are not purchased via casemix. Excluded Spinal Services are those with the Health Speciality Code S50 Spinal Surgery. Events where the admission type is WN (Waiting List) map to S50002 Spinal Services non-acute, and all other admission types map to S50001 Spinal Services acute cases. Surgical Termination of Pregnancy – 2nd Trimester (S30009) – 14 to 25 completed weeks Non-acute Surgical Termination of Pregnancy (ToP) events are excluded. These are tested for by checking that:
wiesnz14_v1.3_november_2014.docx