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Scientific Data Documentation
National Hospital Discharge Survey, 1998
 DSN: CC36.NHDS98


Abstract

This material provides documentation for users of the 1998 NHDS Public Use Data Tape. The NHDS
is conducted annually by the National Center for Health Statistics (NCHS) and is a principal source of
information on inpatient hospital utilization in the United States.

Section I describes the survey and includes information on the history and scope of the NHDS; the
methodology followed, including data collection and medical coding procedures; population estimates;
measurement errors and sampling errors.

Section II provides technical details of the tape.

Section III provides a detailed description of the contents of each data record.

Appendix A defines certain terms used in this document;

Appendix B lists the ICD-9-CM Addenda;

Appendix C provides population estimates to allow the user to calculate rates; and Appendix D provides
unweighted and weighted frequencies for selected
variables.

Description of  The National Hospital Discharge Survey

Introduction.

This document and its appendices contain information for users of the 1998 National Hospital Discharge
Survey (NHDS) public use data file. Conducted annually by the National Center for Health Statistics,
NHDS collects medical and demographic information from a sample of discharge records selected
from a national sample of non-Federal, short-stay hospitals. The data serve as a basis for calculating statistics
on inpatient hospital utilization in the United States. For a description of the survey design and data collection
procedures, see below. For a more detailed description of the survey design, data collection procedures, and
the estimation process, see Reference 1. Publications based on the data for each survey year can be obtained
from the Government Printing Office.

History.

To provide more complete and precise information on the utilization of the Nation's hospitals and
on the nature and treatment of illness among the hospitalized population, in 1962 the NCHS began exploring
possibilities for surveying morbidity in hospitals. A national advisory group was established. The NCHS
conducted planning discussions with other officials of the Public Health Service. Hospitalization material from
the Survey Research Center of the University of Michigan, the American Hospital Association, and the
Professional Activities Study was examined and evaluated. In 1963, a study by the School of Public Health
of the University of Pittsburgh under contract to the NCHS demonstrated the feasibility of an NHDS type
of program. An additional pilot study using enumerators from the Bureau of the Census was conducted in
late 1964 and confirmed the University of Pittsburgh's findings.

Finally, with advice and support from the American Hospital Association, the American Medical Association,
individual experts, other professional groups, and officials of the U.S. Public Health Service, the NCHS
initiated the National Hospital Discharge Survey in 1964.

Survey Methodology

Source of the Data.

The National Hospital Discharge Survey (NHDS) covers discharges from noninstitutional hospitals,
exclusive of Federal, military, and Veterans Administration hospitals, located in the 50 States and
the District of Columbia. Only short-stay hospitals (hospitals with an average length of stay
for all patients of less than 30 days) or those whose specialty is general (medical or surgical) or children's
general are included in the survey. These hospitals must also have six or more beds staffed for patient use.
These criteria, used from 1988 through the current survey year, differ slightly from those used prior to 1988.

Beginning in 1988, the NHDS sampling frame consisted of hospitals that were listed in the April 1987 SMG
Hospital Market Tape (2), met the above criteria, and began accepting patients by August 1987. The hospital
sample was updated in 1991, 1994, and 1997, to allow for hospitals that opened later or changed their eligibility
status since the previous sample update. For 1998 the sample consisted of 513 hospitals. Of the 513
hospitals, 18 were found to be out of scope (ineligible) because they went out of business or otherwise failed
to meet the criteria for the NHDS universe. Of the 495 inscope (eligible) hospitals, 478 hospitals responded
to the survey.

Sample design and data collection.

 The NCHS has conducted the NHDS continuously since 1965.  The original sample was selected
 in 1964 from a frame of short-stay hospitals listed in the National Master Facility Inventory (NMFI).
That sample was updated periodically with samples of hospitals that opened later.

Sample hospitals were selected with probabilities ranging from certainty for the largest hospitals to 1 in 40 for
the smallest hospitals. Within each sample hospital, a systematic random sample of discharges was selected.
A report on the design and development of the original NHDS has been published (1).

In 1988, the NHDS was redesigned to provide geographic sampling comparability with other surveys
conducted by the NCHS; to update the sample of hospitals selected into the survey; and to maximize the use
of data collected through automated systems. As did the original design, the redesigned NHDS sample
included with certainty the largest hospitals. The remaining sample of hospitals was based on a stratified,
three-stage design. The first stage consisted of selecting 112 primary sampling units (PSU's) that comprised
a probability subsample of PSU's used in the 1985-94 National Health Interview Survey. The second stage
consisted of selecting non-certainty hospitals from the sample PSU's. At the third stage a sample of
discharges was selected by a systematic random sampling technique.

These changes in the survey may affect trend data. That is, some of the differences between NHDS
statistics based on the 1965-87 sample and statistics based on the sample drawn for the new design may be
due to sampling error rather than actual changes in hospital utilization.

Two data collection procedures were used for the survey. The first was a manual system of sample selection
and data abstraction, used for approximately 59 percent of the responding hospitals. The second was an
automated method, used for approximately 41 percent of the respondent hospitals, that involved the purchase
of computerized data tapes from abstracting service organizations, state data systems, or from the hospitals
themselves.

In the manual system, the sample selection and the transcription of information from the hospital records to
abstract forms were performed at the hospitals. Of the hospitals using this system in 1998, about 33 percent
had the work performed by their own medical records staff. In the remaining hospitals using the manual
system, personnel of the U.S. Bureau of the Census did the work on behalf of NCHS. The completed forms,
along with sample selection control sheets, were forwarded to NCHS for coding, editing, and weighting.

For the automated system, NCHS purchased tapes containing machine-readable medical record data from
which records were systematically sampled by NCHS.

The Medical Abstract Form (Figure 1) and the automated data contain items relating to the personal
characteristics of the patient, including birth date or age, sex, race, and marital status, but not name and
address; administrative information, including admission and discharge dates, discharge status, and medical
record number; and medical information, including diagnoses and surgical and nonsurgical procedures. Since
1977, patient zip code, expected source of payment, and dates of surgery have also been collected. (The
medical record number, date of birth, and patient zip code are confidential information and are not available
to the public.)

Medical Coding and Edits.

The medical information that was recorded manually on the sample patient abstracts was coded centrally
by NCHS staff. A maximum of seven diagnostic codes was assigned for each
sample abstract. In addition,
if the medical information included surgical or nonsurgical procedures, a maximum of four codes for these
procedures was assigned. The system currently used for coding the diagnoses and procedures on the
medical abstract forms as well as on the commercial abstracting services data tapes is the
International Classification of Diseases, 9th Revision, Clinical Modification, or ICD-9-CM (3).

NHDS usually presents diagnoses and procedures in the order they are listed on the abstract form or obtained
from abstract services; however, there are exceptions. For women discharged after a delivery, a code of
V27 from the supplemental classification is entered as the first-listed code, with a code designating either
normal or abnormal delivery in the second-listed position. In another exception, a decision was made to
reorder some acute myocardial infarction diagnoses. If an acute myocardial infarction is listed with other
circulatory diagnoses and is other than the first entry, it is reordered to first position. If a symptom appears
as a first-listed code and a diagnosis appears as a secondary code, the diagnosis replaces the symptom which
is moved back.

These changes in the survey may affect trend data. That is, some of the differences between NHDS
statistics based on the 1965-87 sample and statistics based on the sample drawn for the new design may be
due to sampling error rather than actual changes in hospital utilization.

Two data collection procedures were used for the survey. The first was a manual system of sample selection
and data abstraction, used for approximately 59 percent of the responding hospitals. The second was an
automated method, used for approximately 41 percent of the respondent hospitals, that involved the purchase
of computerized data tapes from abstracting service organizations, state data systems, or from the hospitals
themselves.

In the manual system, the sample selection and the transcription of information from the hospital records to
abstract forms were performed at the hospitals. Of the hospitals using this system in 1998, about 33 percent
had the work performed by their own medical records staff. In the remaining hospitals using the manual
system, personnel of the U.S. Bureau of the Census did the work on behalf of NCHS. The completed forms,
along with sample selection control sheets, were forwarded to NCHS for coding, editing, and weighting.

For the automated system, NCHS purchased tapes containing machine-readable medical record data from
which records were systematically sampled by NCHS.

The Medical Abstract Form (Figure 1) and the automated data contain items relating to the personal
characteristics of the patient, including birth date or age, sex, race, and marital status, but not name and
address; administrative information, including admission and discharge dates, discharge status, and medical
record number; and medical information, including diagnoses and surgical and nonsurgical procedures. Since
1977, patient zip code, expected source of payment, and dates of surgery have also been collected. (The
medical record number, date of birth, and patient zip code are confidential information and are not available
to the public.)

Following conversion of the data on the medical abstract to computer tape and combining it with the
automated data tapes, a final medical edit was accomplished by computer inspection and by a manual review
of rejected records. Priority was given to medical information in the editing decision.

A new edit program was developed for the NHDS and was implemented beginning in the 1996 data year.
The updated edit program, while following the same general specifications as the previous edit program, was
designed to make as few changes as possible in the data. Thus, there may be some minor anomalies in
certain areas which would be apparent when examining data over time, performing trend analyses, or
examining combinations of variables. Particular features of the new edit program which may affect certain
variables are:

  • An improved imputation procedure for missing age and sex data was developed, which maintains
    the known distribution of these variables, according to categories of the First-Listed Diagnosis.
  • There is no longer a re-ordering of the procedure codes.
  • Principal and additional expected sources of payment are no longer re-ordered, with one
    exception: "Self-Pay" is listed as the principal source only if there are no other sources, or the only
    other source is "Not Stated"; otherwise it must be listed after every other source (except "Not
    Stated").
  • An arbitrary month of admission is no longer assigned to records received from abstract services
    which do not provide the exact date of admission and discharge.

Users of the National Hospital Discharge Survey (NHDS) diagnostic and/or procedure data, which is coded
to the ICD-9-CM, must take into account annual ICD-9-CM addenda. The addenda lists new codes, new
fourth or fifth digits to existing codes, as well as other modifications. Changes go into effect October 1 of
the calendar year. A list of the changes for 1986 through 1997 are listed in Appendix B. All coding of the
1998 data is consistent with the ICD-9-CM and the addendum effective October 1, 1997. Information
provided by automated systems for the last three months of 1998 which was coded using the October 1998
addendum was converted back to the previous code assignment. This was done in order to prevent NHDS
data users from mistaking partial year estimates for annual estimates.

The Uniform Hospital Discharge Data Set (UHDDS).

Starting with 1979 data, the NHDS has followed guidelines of the Uniform Hospital Discharge Data Set (UHDDS) within the confines of its contractual agreement with participating hospitals. The UHDDS is a minimum data set of items uniformly defined (4).  These items were selected on the basis of their usefulness to a broad range of organizations and agencies requiring hospital information, uniformity of definition, and general availability from medical records and abstract services.

Population Estimates.

Appendix C shows estimates of the civilian population of the United Stated as of July 1, 1998, which have been
provided by the U.S. Bureau of the Census. Figures are consistent with national population estimates in US-98-SIS-7 (U.S. Population Estimates by Age, Sex, Race and Hispanic Origin: 1998) and have been adjusted for net underenumeration using the 1990 National Population Adjustment Matrix.
NOTE THAT PRIOR TO THE 1997 DATA YEAR, CENSUS ESTIMATES OF THE CIVILIAN
POPULATION PROVIDED WITH THE NHDS PUBLIC USE DATA TAPE DOCUMENTATION WERE NOT ADJUSTED FOR THE UNDERCOUNT.

Confidentiality

Persons using the public use file agree to abide by the confidentiality restrictions that accompany use of the
data. Specifically, they agree that, in the event of inadvertent discovery of the identity of any individual or
establishment, then: (a) no use will be made of this knowledge; (b) the director of NCHS will be advised of
the incident; (c) the information that would identify the individual or establishment will be safe-guarded or
destroyed, as requested by NCHS; and (d) no one else will be informed of the discovered identity.

Maintaining the confidentiality of survey respondents, whether individuals or establishments, is a responsibility
of NCHS as described in section 308(d) of the Public Health Service Act. As such it may be necessary for
NCHS to block the release of data or modify variables that may, because of their unique nature, lead to
inadvertent disclosure of the identity of a participating facility or respondent.

Measurement Errors.

As in any survey, results are subject to nonsampling or measurement errors, which include errors due to hospital nonresponse, missing abstracts, information incompletely or inaccurately recorded on abstract forms, and processing errors.  A very small proportion, (less than one-half of one percent) of the discharge records failed to include the sex, age, or date of birth of the patient.  If the hospital record did not state either the age or sex of patient, it was imputed by assigning an age or sex value according to the specifications described earlier. In a very few cases (about a quarter of a percent of the records), the age or sex was edited, because it was inconsistent with the diagnosis.  Data on race were missing for 22.3 percent of the discharges, and no attempt was made to impute for these missing values.

During 1998, 18.5 percent of the records lacked the date of admission, but included a length of stay. Because the new edit program does not require exact admission or discharge dates if length of stay is provided on the
record, no attempt was made to impute for these missing values.  Other edit and imputation procedures may have been applied to data in the NHDS collected in automated form.

Sampling errors and rounding of numbers.

The standard error is primarily a measure of sampling variability that occurs by chance because only a sample rather than the entire universe is surveyed. The relative standard error of the estimate is obtained by dividing the standard error by the estimate itself.  The resulting value is multiplied by 100, so the relative standard error is expressed as a percent of the estimate.  Estimates of sampling variability were calculated with SUDAAN software, which computes standard errors by using a first-order Taylor series approximation of the deviation of estimates from their expected values. A description of the software and the approach it uses was published by Shah, Barnwell, and Bieler (5).

Relative Standard Errors for Aggregate Estimates

Parameters for calculating approximate relative standard errors for aggregate estimates are presented in
Table 1. To derive error estimates that would be applicable to a wide variety of statistics, numerous estimates
and their variances were produced. A regression model was then used to produce best-fit curves, based on
the empirically determined relationship between the size of an estimate X and its relative variance. The
relative standard error of an estimate X [RSE(X)] is the square root of the relative variance and may be
calculated from the formula:

RSE(X) = SQRT(a + b/X)

with a and b provided in Table 1. When multiplied by 100, the RSE(X) is expressed as a percent of X.

For example, in 1998 the estimated number of discharges from short-stay hospitals for females with a first-listed diagnosis of atherosclerotic heart disease (ICD-9-CM code 414.0) was 426,000.   Using the applicable constants from Table 1 for estimates by sex produces:

RSE(426,000) = SQRT(.00139 + (319.01469/426,000))

RSE(426,000) = .046

When multiplied by 100, the relative standard error for the estimate of interest becomes 4.6 percent. The
standard error of the estimate is obtained by multiplying the relative standard error by the estimate itself:

SE(426,000) = 426,000 * .046 = 19,596

The standard error can be used to generate confidence intervals for statistical testing. In this example, the
95% confidence interval for the estimate of female inpatients with a first-listed diagnosis of
atherosclerotic heart disease is:

(426,000 - 2*19,596) <-> (426,000 + 2*19,596)

387,000 <-> 465,000


Relative Standard Error for Estimates of Percents

Approximate relative standard errors for estimates of percents may be calculated from Table 1 also. The
relative standard error for a percent, 100 p (0<p<1) may be calculated using the formula:

RSE(p) = SQRT(b * (1 - p)/(p * X))

where 100p is the percent of interest, X is the base of the percent, and b is the parameter b in the formula
for approximating the RSE(X). The values for b are given in Table 1. When multiplied by 100, the RSE(p)
is expressed as a percent of the estimate, p.

For example, in 1998 the estimated number of discharges from short-stay hospitals which were female was
19,358,000. This is 60.8 percent of the estimated 31,827,000 discharges for that year. Using the applicable
constants from Table 1 for estimates by sex produces:

RSE(.608) = SQRT(319.01469 * (1 - .608)/(.608 * 31,827,000))

RSE(.608) = .002542

When multiplied by 100, the relative standard error for the estimate of interest becomes .2542 percent. From
this the standard error is obtained by multiplying the relative standard error by the estimate itself:

SE(.608) = .608* 0.002542 = .0015

The standard error can be used to generate confidence intervals for statistical testing. In this example, the
95% confidence interval for the estimate of the percentage of female inpatients is:

(.608 - 2*.0015) <-> (.608 + 2*.0015)

.605 <-> .611

or,equivalently,

60.5% <-> 61.1%


Relative Standard Error for Ratio Estimators

The approximate RSE of a ratio (X/Y) in which the numerator (X) and the denominator (Y) are both
estimated from the same survey, but the numerator is not a subclass of the denominator, is calculated using
the formula:

RSE(X/Y) = SQRT(RSE^2(X) + RSE^2(Y))

The approximation is valid if the RSE of the denominator is less than 5 percent or the RSE's of the numerator
and denominator are both less than 10 percent. When multiplied by 100, the RSE(X/Y) is expressed as a
percent of the ratio estimate, X/Y.

For example, average length of stay (ALOS) is considered a ratio estimator since it is the ratio of days of care
to the number of discharges. In 1998, the estimated number of days of care for inpatients with a first-listed
diagnosis of asthma (ICD-9-CM code 493) was 1,403,000. The estimated number of discharges for inpatients
with a first-listed diagnosis of asthma was 423,000. The ALOS for inpatients with a first-listed diagnosis of
asthma was 1,403,000/423,000 = 3.3.

To compute the RSE for ALOS, first compute the RSE for the estimated number of days of care and the
RSE for the estimated number of discharges. See the section above on
Relative Standard Errors for
Aggregate Estimates
for computation of these RSE's.

RSE(1,403,000) = .0572

RSE(423,000) = .0476

Next, substitute those RSE's into the formula above to approximate the RSE for the ALOS estimate:

RSE(3.3) = SQRT((.0572)^2 + (.0476)^2)

RSE(3.3) = .0744

The standard error of the estimate is obtained by multiplying the relative standard error by the estimate
itself:

SE(3.3) = .0744 * 3.3 = .246

The standard error can be used to generate confidence intervals for statistical testing. In this example,
the 95% confidence interval for the estimate of the ALOS for inpatients diagnosed with asthma is:

(3.3 - 2*.246) <-> (3.3 + 2*.246)

2.8 <-> 3.8

 

Presentation of Estimates.

Publication of estimates for the NHDS is based on the relative standard error of the estimate and
the number of sample records on which the estimate is based (referred to as the sample size).
Estimates are not presented in NCHS reports unless a reasonable assumption regarding the
probability distribution of the sampling error is possible.

Based on consideration of the complex sample design of the NHDS, the following
guidelines are used forpresenting the NHDS estimates:

If the sample size is less than 30, the value of the estimate is not reported.

If the sample size is 30-59, the value of the estimate is reported but should not be assumed
reliable.

If the sample size is 60 or more and the relative standard error is less than 30 percent, the
estimate is reported.

If the relative standard error of any estimate is over 30 percent, the estimate is considered
to be unreliable. It is left to the author to decide whether or not to present it. However, if
the author chooses to present the unreliable estimate, the consumer of the statistic must be
informed that the statistic is not reliable.

Monthly and Seasonal Estimates Under the New Design.

An important difference between the old and new designs is the method used to adjust for nonresponse.
In the old design, weights for responding hospitals were adjusted each month to account for hospitals
that did not respond for that month. In the new design, the type of nonresponse adjustment applied
depended on whether the hospital was considered a nonrespondent or partial respondent. A nonresponding hospital was one which failed to provide at least half of the expected number of discharges for at least half
of the months for which it was inscope. In this case, weights of discharges from hospitals similar to the nonresponding hospital were inflated to account for discharges of the nonrespondent hospital. However, this adjustment was performed just once, after the close out of the survey for the year, instead of monthly as before.

For partially responding hospitals, one or both of two adjustments were made. If the hospital provided at least
half, but not all, of the expected number of abstracts for a given month, the weights of the abstracts actually
collected for that month were inflated to account for the missing abstracts. If fewer than half of the expected
number of abstracts were provided, the weights of the abstracts provided were inflated by a factor of two,
then a second adjustment was made to account for the excess nonresponse. In the second adjustment, the
weights of the discharges in the hospital's respondent months were inflated by ratios that varied by category
of first-listed ICD-9-CM diagnostic code. This adjustment ratio was based on the hospital's month(s) of
nonresponse and the month-by-month distributions of first-listed diagnostic groups among discharges from
hospitals which responded for all twelve months. The ratio accounts for the seasonality in the occurrence
of the first-listed diagnostic groups for annual statistics, but not for partial year estimates. As a result monthly
and seasonal estimates may be skewed. While the effect is believed to be small, it is recommended that
partial year estimates NOT be produced. In the 1998 NHDS, 88.7 percent of the 478 responding hospitals
provided data for all twelve months, and 96.2 percent provided at least nine months of data.

How to Use the Data Tape.

The NHDS records are weighted to allow inflation to national or regional estimates. The weight applied to
each record is found in tape location 21-25. To produce an estimate of the number of discharges, the
weights for the desired records must be summed. To produce an estimate for number of days of care,
the weight must be multiplied by the days of care (tape location 13-16) and these products are summed.
Average length of stay data can be obtained by dividing the days of care by the number of discharges as calculated above.

Appendix D contains unweighted and weighted frequencies for selected variables on the data tape.
These may be used as a cross-check when processing the data on the user's system.

Diagnosis-Related Groups (DRGs).

Many users of the NHDS data tapes have expressed an interest in converting the data to DRGs.
This has been done using DRG Grouper Programs obtained from the Health Care Financing Administration.
The DRGs and the DRG Grouper Programs were developed outside of the National Center for Health Statistics; any questions about DRGs, other than specific questions about how they relate to NHDS data, should be addressed elsewhere.

Questions.

Questions concerning data on the tape should be directed to:

Jen Popovic, M.A.
Centers for Disease Control and Prevention
National Center for Health Statistics
Division of Health Care Statistics
Hospital Care Statistics Branch
6525 Belcrest Road, Room 956
Hyattsville, Maryland 20782
Phone: 301.458.4321
Fax: 301.458.4032
Email:
jpopovic@cdc.gov

For more information about the NHDS, visit our website:
http://www.cdc.gov/nchs/about/major/hdasd/nhds.htm

For email discussions and dissemination of NHDS data,
join our Hospital Discharge and Ambulatory SurgeryData listserv (HDAS-DATA).
In the body of an email message (leaving the subject line blank), type:

subscribe hdas-data Your Name

Send this message to:
listserv@cdc.gov


References

1 National Center for Health Statistics: Development of the design of the NCHS Hospital Discharge Survey, by
  W. R. Simmons. Vital and Health Statistics. PHS Pub. No. 1000, Series 2-No. 39.  Public Health
Service. 
  Washington. U.S. Government Printing Office, Sept. 1970.

2 SMG Marketing Group, Inc. Hospital Market Database. Healthcare Information Specialists,  1342 North  
  LaSalle Drive, Chicago, IL. 1987, April 1991, April 1994, April 1997.

3 Public Health Service and Health Care Financing Administration. International Classification of Diseases, 9th  
  Revision, Clinical Modification. Washington, DC: U.S. Public Health Service. 4th edition. 1991.

4 Office of the Secretary, Department of Health and Human Services: Health Information Policy Council: 1984
   Revision of the Uniform Hospital Discharge Data Set. Federal Register, Volume 50, No. 147. July 31, 1985.

5 Shah, Babubhai.V., Beth G. Barnwell, and Gayle S. Bieler. SUDAAN User's Manual: Software for
  Analysis of Correlated Data, Release 6.40.
Research Triangle Institute: Research Triangle Park, N.C. 1997.


Record Layout:  Location and Coding of Data Elements

This section provides detailed information for each sampled record on the tape, with a description of each item included on the record. Data elements are arranged sequentially according to their physical location on the tape record. Unless otherwise stated in the Item Description, the data are derived from the abstract form or from automated sources. The SMG Hospital Market Tape and the hospital interview are alternate sources of data; some other items are computer generated.

Please note that the location and coding of some variables in 1998 differs from previous years.
Please pay particular attention to the following:

  • Discharge month replaces admission month in position 10-11.
  • The principal and expected source of payment variables are now two-digit as opposed to
    one-digit variables.  They also have different values and different positions than in previous years.
  • A century variable (the first two digits of the survey year) now appears in position 26-27.
  • DRG is located in position 83-85.

 

Item      Tape       Number of
Number    Location   Positions     Item description    Code description
  1         1-2          2          Survey Year         98

  2          3           1          Newborn status      1=Newborn
                                                        2=Not newborn

  3          4           1          Units for age       1=Years
                                                        2=Months
                                                        3=Days

  4         5-6          2          Age in years, 
                                    months, or days     If units=years: 00-99*
                                                        If units=months: 01-11
                                                        If units=days: 00-31
                                                        *Ages 100 and over were 
                                                          recoded to 99

  5          7           1           Sex               1=Male
                                                       2=Female

  6          8           1           Race              1=White
                                                       2=Black
                                                       3=American Indian/Eskimo
                                                       4=Asian/Pacific Islander
                                                       5=Other
                                                       9=Not stated

  7          9           1           Marital status    1=Married
                                                       2=Single
                                                       3=Widowed
                                                       4=Divorced
                                                       5=Separated
                                                       9=Not stated

  8        10-11         2          Discharge month    01-12=January to December
                                                       99=Missing
Item      Tape       Number of
Number    Location   Positions     Item description     Code description
  9          12          1          Discharge status    1=Routine/discharged home
                                                        2=Left against medical advice
                                                        3=Discharged/transferred to 
                                                          short-term facility
                                                        4=Discharged/transferred to 
                                                          long-term care institution
                                                        5=Alive, disposition not stated
                                                        6=Dead
                                                        9=Not stated or not reported

 10        13-16         4          Days of care        Use to calculate number of 
                                                        days of care. Values of zero 
                                                        generated by the computer from 
                                                        admission and discharge dates 
                                                        were changed to one. (Discharges 
                                                        for which dates of admission and 
                                                        discharge are the same are 
                                                        identified in Item Number 11)

 11         17           1          Length of stay 
                                    flag                0=Less than 1 day
                                                        1=One day or more
 
 12         18           1          Geographic region   1=Northeast
                                                        2=Midwest
                                                        3=South
                                                        4=West

 13         19           1          Number of beds, 
                                    recode              1=6-99
                                                        2=100-199
                                                        3=200-299
                                                        4=300-499
                                                        5=500 and over

 14         20           1          Hospital ownership  1=Proprietary
                                                        2=Government
                                                        3=Nonprofit, including church

 15        21-25         5          Analysis weight     Use to obtain weighted estimates

 16        26-27         2          First two digits 
                                    of survey year      19

 17        28-32         5          Diagnosis code #1   *
Item      Tape       Number of
Number    Location   Positions     Item description    Code description
 18        33-37         5          Diagnosis code #2   *

 19        38-42         5          Diagnosis code #3   *

 20        43-47         5          Diagnosis code #4   *

 21        48-52         5          Diagnosis code #5   *

 22        53-57         5          Diagnosis code #6   *

 23        58-62         5          Diagnosis code #7   *

 24        63-66         4          Procedure code
                                    #1                  *

 25        67-70         4          Procedure code
                                    #2                  *

 26        71-74         4          Procedure code
                                    #3                  *

 27        75-78         4          Procedure code
                                    #4                  *

 28        79-80         2          Principal
                                    expected source
                                    of payment          01=Worker's comp
                                                        02=Medicare
                                                        03=Medicaid
                                                        04=Other government
                                                        05=Blue Cross/Blue Shield
                                                        06=HMO/PPO
                                                        07=Other private
                                                        08=Self-pay
                                                        09=No charge
                                                        10=Other
                                                        99=Not stated

 29       81-82          2          Secondary
                                    expected source
                                    of payment          Same coding as item 28 above

 30       83-85          3          Diagnosis-Related
                                    Groups (DRG)        Grouper version 15.0

*Diagnosis and procedure codes are in compliance with the International Classification of Diseases, 9th Revision, Clinical
Modification, (ICD-9-CM
). For diagnosis codes, there is an implied decimal between positions 3 and 4. For E-codes, the implied
decimal is between the 4th and 5th position. For inapplicable 4th or 5th digits, a dash is inserted. For
procedure codes, there is an
implied decimal between positions 2 and 3. For inapplicable 3rd or 4th digits, a dash is inserted.

 

Appendix  A

Definition Of Terms

Terms relating to hospitals and hospitalization

Hospitals: Short stay hospitals or hospitals whose specialty is general (medical or surgical), or children's
general. Hospitals must have 6 beds or more staffed for patients use. Federal hospitals and hospital units
of institutions are not included.

Type of ownership of hospital: The type of organization that controls and operates the hospital. Hospitals
are grouped as follows:

Not for Profit: Hospitals operated by a church or another not for profit organization.

Government: Hospitals operated by State and local government.

Proprietary: Hospitals operated by individuals, partnerships, or corporations for profit.

Patient: A person who is formally admitted to the inpatient service of a short-stay hospital for observation,
care, diagnosis, or treatment, or by birth.

Discharge: The formal release of a patient by a hospital; that is, the termination of a period of hospitalization
by death or by disposition to place of residence, nursing home, or another hospital. The terms "discharges"
and "patients discharged" are used synonymously.

Discharge rate: The ratio of the number of hospital discharges during the year to the number of persons in
the civilian population on July 1 of that year.

Days of care : The total number of patient days accumulated at time of discharge by patients discharged
from short: stay hospitals during a year. A stay of less than 1 day (patient admission and discharge on the
same day) is counted as 1 day in the summation of total days of care. For patients admitted and discharged
on different days, the number of days of care is computed by counting all days from (and including) the date
of admission to (but not including) the date of discharge.

Rate of days of care : The ratio of the number of patient days accumulated at time of discharge to the
number of persons in the civilian population on July 1 of that year.

Average length of stay: The total number of days of care accumulated at time of discharge by patients
discharged during the year, divided by the number of patients discharged.

Terms relating to diagnoses and procedures

Discharge diagnoses: One or more diseases or injuries (or some factor that influences health status and
contact with health services that is not itself a current illness or injury) listed by the attending physician on the
medical record of a patient. In the NHDS, discharge (or final) diagnoses listed on the face sheet (summary
sheet) of the medical record are transcribed in the order listed. Each sample discharge is assigned a
maximum of seven five-digit codes according to ICD-9-CM (2).

Principal diagnosis: The condition established after study to be chiefly responsible for occasioning the
admission of the patient to the hospital for care.

First-listed diagnosis: The coded diagnosis identified as the principal diagnosis or listed first on the face
sheet of the medical record if the principal diagnosis cannot be identified. The number of first-listed diagnoses
is equivalent to the number of discharges.

Procedure: One or more surgical or nonsurgical operations, procedures, or special treatments listed by the
physician on the medical record. In the NHDS, all terms listed on the face sheet (summary sheet) of the
medical record under the caption "operation," "operative procedures," "operations and/or special treatment,"
and the like are transcribed in the order listed. A maximum of four procedures are coded.

Rate of procedures: The ratio of the number of all-listed procedures during a year to the number of persons
in the civilian population on July 1 of that year determines the rate of procedures.

Demographic terms

Age: Refers to the age of the patient on the birthday prior to admission to the hospital inpatient service.

Population: Civilian population is the resident population excluding members of the Armed Forces.

Geographic regions : Hospitals are classified by location in one of the four geographic regions of the United
States corresponding to those used by the U.S. Bureau of the Census:

U.S. Census  Regions

 Northeast           Midwest            South                  West
 Maine               Michigan           Delaware               Montana
 New Hampshire       Ohio               Maryland               Idaho
 Vermont             Illinois           District of Columbia   Wyoming
 Massachusetts       Indiana            Virginia               Colorado
 Connecticut         Wisconsin          West Virginia          New Mexico
 Rhode Island        Minnesota          North Carolina         Arizona
 New York            Iowa               South Carolina         Utah
 New Jersey          Missouri           Georgia                Nevada
 Pennsylvania        North Dakota       Florida                Washington
                     South Dakota       Kentucky               Oregon
                     Nebraska           Tennessee              California
                     Kansas             Alabama                Hawaii
                                        Mississippi            Alaska
                                        Arkansas
                                        Louisiana
                                        Oklahoma
                                        Texas

Appendix B

The International Classification of Diseases, 9th Revision, Clinical Modification, which has been used
for coding NHDS data since 1979, undergoes annual updating. Assignment of new diagnostic and procedure
codes, fourth and fifth digit expansion of codes, as well as code deletions, are contained in addenda developed
by the ICD-9-CM Coordination and Maintenance Committee and approved by the Director of NCHS and
the Administrator of the Health Care Financing Administration. Addenda to the ICD-9-CM become effective
on October 1 of the calendar year and have been released for 1986 through 1998.

As described earlier in this document, the 1998 NHDS involved two data collection modes: manual and
abstract service. All data collected manually were coded using the third edition of the ICD-9-CM, which
includes the addenda for 1986 through 1997. Data collected via abstract service were coded using two
different ICD-9-CM revisions. For the first 9 months of 1998, the ICD-9-CM including the addendum of
October 1, 1986-97 was used; for the last 3 months the October 1998 addendum was used. Therefore, data
provided by automated systems for the last three months of 1998 was converted back to the code assignment
under the October 1997 addendum. This was done in order to prevent NHDS data users from mistaking
partial year estimates for annual estimates.

In order to assist users in data retrieval, a conversion table is provided that shows the date of introduction
of each new code and the previously assigned code equivalent, which had been used for reporting the selected
diagnosis or procedure prior to issuance of the new code.

 

DIAGNOSIS CODES

Current code(s) assignmentEffective 
October 1
Previous code(s) assignment
005.81 1995 005.8
005.89 1995 005.8
007.4 1997 007.8
008.00-008.09 1992 008.0
008.43-008.47 1992 008.49
008.61-008.69 1992 008.6
031.2 1997 031.8
038.10 1997 038.1
038.11 1997 038.1
038.19 1997 038.1
041.00-041.09 1992 041.0
041.04 (code title restated) 1997 041.04
041.10-041.19 1992 041.1
041.81-041.85 1992 041.8
041.86 1995 041.84
041.89 1992 041.8
042 1994 042.0-042.2, 042.9, 043.0-043.3,
043.9, 044.0, 044.9 (Codes deleted)
042.0-042.9 1986 279.19
043.0-043.9 1986 279.19
044.0-044.9 1986 279.19
070.20-070.21 1991 070.2
070.22 1994 070.20
070.23 1994 070.21
070.30-070.31 1991 070.3
070.32 1994 070.30
070.33 1994 070.31
070.41-070.43 1991 070.4
070.44 1994 070.41
070.49 1991 070.4
070.51-070.53 1991 070.5
070.54 1994 070.51
070.59 1991 070.5
077.98-077.99 1993 077.9
078.10-078.11,078.19 1993 078.1
078.88 1993 078.89
079.4 1993 079.8
079.50-079.53,079.59 1993 079.8
079.6 1996 079.89
079.81 1995 079.89
079.88-079.89 1993 079.8
079.98-079.99 1993 079.9
088.81,088.89 1989 088.8
088.82 1993 088.89
099.40-099.49 1992 099.4
099.50-099.59 1992 078.89
112.84-112.85 1992 112.89
114.4-114.5 1993 114.3
176.0-176.9 1991 173.0-173.9
203.00 1991 203.0
203.01 1991 V10.79
203.10 1991 203.1
203.11 1991 V10.79
203.80 1991 203.8
203.81 1991 V10.79
204.00 1991 204.0
204.01 1991 V10.61
204.10 1991 204.1
204.11 1991 V10.61
204.20 1991 204.2
204.21 1991 V10.61
204.80 1991 204.8
204.81 1991 V10.61
204.90 1991 204.9
204.91 1991 V10.61
205.00 1991 205.0
205.01 1991 V10.62
205.10 1991 205.1
205.11 1991 V10.62
205.20 1991 205.2
205.21 1991 V10.62
205.30 1991 205.3
205.31 1991 V10.62
205.80 1991 205.8
205.81 1991 V10.62
205.90 1991 205.9
205.91 1991 V10.62
206.00 1991 206.0
206.01 1991 V10.63
206.10 1991 206.1
206.11 1991 V10.63
206.20 1991 206.2
206.21 1991 V10.63
206.80 1991 206.8
206.81 1991 V10.63
206.90 1991 206.9
206.91 1991 V10.63
207.00 1991 207.0
207.01 1991 V10.69
207.10 1991 207.1
207.11 1991 V10.69
207.20 1991 207.2
207.21 1991 V10.69
207.80 1991 207.8
207.81 1991 V10.69
208.00 1991 208.0
208.01 1991 V10.60
208.10 1991 208.1
208.11 1991 V10.60
208.20 1991 208.2
208.21 1991 V10.60
208.80 1991 208.8
208.81 1991 V10.60
208.90 1991 208.9
208.91 1991 V10.60
237.70-237.72 1990 237.7
250.02 1993 250.90
250.03 1993 250.91
250.12 1993 250.10
250.13 1993 250.11
250.22 1993 250.20
250.23 1993 250.21
250.32 1993 250.30
250.33 1993 250.31
250.42 1993 250.40
250.43 1993 250.41
250.52 1993 250.50
250.53 1993 250.51
250.62 1993 250.60
250.63 1993 250.61
250.72 1993 250.70
250.73 1993 250.71
250.82 1993 250.80
250.83 1993 250.81
250.92 1993 250.90
250.93 1993 250.91
275.40-275.42 1997 275.4
275.49 1997 275.4
278.00-278.01 1995 278.0
283.10-283.11,283.19 1993 283.1
291.81 1996 291.8
291.89 1996 291.8
293.84 1996 293.89
300.82 1996 300.81
305.1 1994 305.10, 305.11, 305.12,
305.13 (Codes deleted)
312.81-312.82,312.89 1994 312.8
315.32 1996 315.39
320.81-320.89 1992 320.8
333.92-333.93 1994 333.99
337.20-337.22,337.29 1993 337.9
342.00-342.02 1994 342.0
342.10-342.12 1994 342.1
342.80-342.82 1994 342.9
342.90-342.92 1994 342.9
344.00-344.04,344.09 1994 344.0
344.30-344.32 1994 344.3
344.40-344.42 1994 344.4
344.81,344.89 1993 344.8
345.00-345.01 1989 345.0
345.10-345.11 1989 345.1
345.40-345.41 1989 345.4
345.50-345.51 1989 345.5
345.60-345.61 1989 345.6
345.70-345.71 1989 345.7
345.80-345.81 1989 345.8
345.90-345.91 1989 345.9
346.00-346.01 1992 346.0
346.10-346.11 1992 346.1
346.20-346.21 1992 346.2
346.80-346.81 1992 346.8
346.90-346.91 1992 346.9
355.71 1993 354.4
355.79 1993 355.7
371.82 1992 371.89
374.87 1990 374.89
403.00-403.01 1989 403.0
403.10-403.11 1989 403.1
403.90-403.91 1989 403.9
404.00-404.03 1989 404.0
404.10-404.13 1989 404.1
404.90-404.93 1989 404.9
410.00-410.02 1989 410.0
410.10-410.12 1989 410.1
410.20-410.22 1989 410.2
410.30-410.32 1989 410.3
410.40-410.42 1989 410.4
410.50-410.52 1989 410.5
410.60-410.62 1989 410.6
410.70-410.72 1989 410.7
410.80-410.82 1989 410.8
410.90-410.92 1989 410.9
411.81 1989 410.9
411.89 1989 411.8
414.00-414.01 1994 414.0
414.02-414.03 1994 996.03
414.04-414.05 1996 414.00
415.11 1995 997.3 & 415.1
415.19 1995 415.1
429.71 1989 410.0-410.9
429.79 1989 410.0-410.9
433.00-433.01 1993 433.0
433.10-433.11 1993 433.1
433.20-433.21 1993 433.2
433.30-433.31 1993 433.3
433.80-433.81 1993 433.8
433.90-433.91 1993 433.9
434.00-434.01 1993 434.0
434.10-434.11 1993 434.1
434.90-434.91 1993 434.9
435.3 1995 435.0 & 435.1
437.7 1992 780.9
438.0 1997 294.9 & 438
438.10 1997 784.5 & 438
438.11 1997 784.3 & 438
438.12 1997 784.4 & 438
438.19 1997 784.5 & 438
438.20 1997 342.90 & 438
438.21 1997 342.91 & 438
438.22 1997 342.92 & 438
438.30 1997 344.40 & 438
438.31 1997 344.41 & 438
438.32 1997 344.42 & 438
438.40 1997 344.30 & 438
438.41 1997 344.31 & 438
438.42 1997 344.32 & 438
438.50-438.52 1997 344.89 & 438
438.81 1997 784.69 & 438
438.82 1997 787.2 & 438
438.89 1997 438
438.9 1997 438
440.20-440.22 1992 440.2
440.23 1993 440.20 & 707.1 or 707.8 or 707.9
440.24 1993 440.20 & 785.4
440.29 1993 440.2
440.30-440.32 1994 996.1
441.00-441.03 1994 441.0
441.6 1993 441.1 & 441.3
441.7 1993 441.2 & 441.4
446.20-446.21,446.29 1990 446.2
451.82-451.84 1993 451.89
458.2 1995 997.9 & 458.9
458.8 1997 458.9
466.11 1996 466.1
466.19 1996 466.1
474.0 (code title restated) 1997 474.0
474.00-474.02 1997 474.0
482.30-482.39 1992 482.3
482.81-482.89 1992 482.2
482.84 1997 482.83
483.0 1992 483
483.1 1996 078.88 & 484.8
483.8 1992 483
491.20-491.21 1991 491.2
493.20 1989 493.90
493.21 1989 493.91
512.1 1994 997.3
518.6 1997 518.89
518.81 1987 799.1
518.82-518.89 1987 518.8
524.00-524.09 1992 524.0
524.10-524.19 1992 524.1
524.60-524.69 1991 524.6
524.70-524.79 1992 524.8
530.10-530.11,530.19 1993 530.1
530.81 1993 530.1
530.82-530.84,530.89 1993 530.8
535.00-535.01 1991 535.0
535.10-535.11 1991 535.1
535.20-535.21 1991 535.2
535.30-535.31 1991 535.3
535.40-535.41 1991 535.4
535.50-535.51 1991 535.5
535.60-535.61 1991 535.6
536.3 1994 536.8
537.82 1990 537.89
537.83 1991 537.82
556.0-556.6 1994 556
556.8-556.9 1994 556
562.02 1991 562.00
562.03 1991 562.01
562.12 1991 562.10
562.13 1991 562.11
569.60-569.61 1995 569.6
569.69 1995 569.6
569.84 1990 557.1
569.85 1991 569.84
574.60 1996 574.00 & 574.30
574.61 1996 574.01 & 574.31
574.70 1996 574.10 & 574.40
574.71 1996 574.11 & 574.41
574.80 1996 574.00 & 574.10
574.30 & 574.40
574.81 1996 574.01 & 574.11
574.31 & 574.41 
574.90 1996 574.20 & 574.50
574.91 1996 574.21 & 574.51
575.10-575.11 1996 575.1
575.12 1996 575.0 & 575.1
593.70-593.73 1994 593.7
596.51-596.53 1992 596.5
596.54 1992 344.61
596.55-596.59 1992 596.5
599.81-599.89 1992 599.8
645.0 1991 645
651.30-651.31,651.33 1989 651.00-651.01,651.03
651.40-651.41,651.43 1989 651.10-651.11,651.13
651.50-651.51,651.53 1989 651.20-651.21,651.23
651.60-651.61,651.63 1989 651.80-651.81,651.83
654.20-654.21,654.23 1990 654.2, 654.9
654.90-654.94 1990 654.2, 654.9
655.70 & 655.71 1997 655.8
655.73 1997 655.8
657.0 1991 657
659.60,659.61,659.63 1992 659.80-659.81,659.83
665.10,665.11 1992 665.10,665.11,665.12,665.14
Note:  The title for the subcategory, 665.1 has been changed, making the fifth-digit subclassification 665.12 and 665.14 invalid.
670.0 1991 670
672.0 1991 672
677 1994 No previous code assignment
686.00 &686.01 1997 686.0
686.09 1997 686.0
690.10 1995 690
690.11 1995 691.8 & 704.8
690.12 1995 691.8
690.18 1995 690
690.8 1995 690
692.72-692.74 1992 692.79
692.82-692.83 1992 692.89
702.0-702.8 1991 702
702.11,702.19 1994 702.1
704.02 1993 704.09
709.00-709.01,709.09 1994 709.0
710.5 1992 288.3,729.1
728.86 1995 729.4
733.10-733.16,733.19 1993 733.1
738.10-738.19 1992 738.1
747.60-747.64,747.69 1993 747.6
747.82 1993 747.89
752.51-752.52 1996 752.5
752.61-752.63 1996 752.6
752.64-752.65 1996 752.8
752.69 1996 752.8
753.10-753.17,753.19 1990 753.1
753.20-753.23 1996 753.2
753.29 1996 753.2
756.70-756.71 1997 756.7
756.79 1997 756.7
759.81-759.82 1989 759.8
759.83 1994 759.89
759.89 1989 759.8
760.75 1991 760.79
760.76 1994 760.79
764.00-764.09 1988 764.0
764.10-764.19 1988 764.1
764.20-764.29 1988 764.2
764.90-764.99 1988 764.9
765.00-765.09 1988 765.0
765.10-765.19 1988 765.1
780.01-780.02 1992 780.0
780.03 1993 780.01
780.09 1992 780.0
780.31 1997 780.3
780.39 1997 780.3
780.57 1992 780.51, 780.53
781.8 1994 781.9
787.01-787.03 1994 787.0
787.91 1995 558.9
787.99 1995 787.9
788.20-788.21, 788.29 1993 788.2
788.30-788.39 1992 788.3
788.41-788.43 1993 788.4
788.61-788.62, 788.69 1993 788.6
789.00-789.07, 789.09 1994 789.0
789.30-789.37, 789.39 1994 789.3
789.40-789.47, 789.49 1994 789.4
789.60-789.67, 789.69 1994 789.6
790.91 1993 790.9
790.92 1993 286.9
790.93, 790.99 1993 790.9
790.94 1997 790.99
795.71 1994 795.8 (Code deleted)
795.79 1994 795.7
795.8 1986 795.7
796.5 1997 796.9
864.05 1992 864.09
864.15 1992 864.19
909.5 1994 909.9
922.31-922.33 1996 922.3
925.1-925.2 1993 925
959.0 (code title restated) 1997 959.0
959.01 1997 854.00
959.09 1997 959.0
989.81-989.84 1995 989.8
989.89 1995 989.8
995.50-995.55 1996 995.5
995.59 1996 995.5
995.60-995.69 1993 995.0
995.80 1996 995.81
995.81 (code title restated) 1996 995.81
995.82-995.85 1996 995.81
996.04 1994 996.09
996.51-996.59 1987 996.5
996.60-996.69 1989 996.6
996.70-996.79 1989 996.7
996.80-996.84 1987 996.8
996.85 1990 996.8
996.86 1987 996.8
996.89 1987 996.8
997.00-997.01 1995 997.0
997.02 1995 997.9 & 430-434, 436
997.09 1995 997.0
997.91 1995 997.9
997.99 1995 997.9
998.11-998.12 1996 998.1
998.13 1996 998.89
998.51 1996 998.5
998.59 1996 998.5
998.81-998.82, 998.89 1994 998.8
998.83 1996 998.89
V02.60-V02.62 1997 V02.6
V02.69 1997 V02.6
V03.81-V03.82, V03.89 1994 V03.8
V05.3-V05.4 1993 V05.8
V06.5-V06.6 1994 V06.8
V07.31,V07.39 1994 V07.3
V07.4 1992 V07.8
V08 1994 044.9, 795.8 (Codes deleted)
V09.0-V09.91 1993 No previous code assignments
V12.00-V12.03, V12.09 1994 V12.0
V12.40-V12.41 1997 V12.4
V12.49 1997 V12.4
V12.50-V12.52 1995 V12.5
V12.59 1995 V12.5
V12.70-V12.72, V12.79 1994 V12.7
V13.00-V13.01, V13.09 1994 V13.0
V15.41-V15.421996V15.4
V15.491996V15.4
V15.821994305.13 (Codes deleted)
V15.84-V15.861995V15.89
V16.40-V16.431997V16.4
V16.491997V16.4
V23.71989V23.8
V25.431992V25.49
V25.51992V25.8
V28.61997V28.8
V29.0-V291, V29.81992V71.8
V29.2
(Note: Codes V29.3-V29.7 have not been
assigned yet)
1994V29.8
V29.91992V71.9
V30.00-V30.011989V30.0
V31.00-V31.011989V31.0
V32.00-V32.011989V32.0
V33.00-V33.011989V33.0
V34.00-V34.011989V34.0
V35.00-V35.011989V35.0
V36.00-V36.011989V36.0
V37.00-V37.011989V37.0
V39.00-V39.011989V39.0
V42.81-V82.831997V42.8
V42.891997V42.8
V43.60-V43.66, V43.691994V43.6
V43.81-V43.821995V43.8
V43.891995V43.8
V45.001994V45.89
V45.011994V45.0
V45.02, V45.091994V45.89
V45.511994V45.5
V45.52, V45.591994V45.89
V45.611997V45.6
V45.631997V45.6
V45.711997611.8
V45.721997569.89
V45.731997593.89
V45.821994V45.89
V45.831995V45.89
V49.60-V49.671994V49.5
V49.70-V49.771994V49.5
V50.41-V50.42, V50.491994V50.8
V53.01-V53.021997V53.0
V53.091997V53.0
V53.311994V53.3
V53.32, V53.391994V53.9
V56.11995V58.89
V57.21-V57.221994V57.2
V58.41, V58.491994V58.4
V58.611995V67.51
V58.691995V67.51
V58.81, V58.891994V58.8
V58.821995V58.89
V59.01-V59.021995V59.0
V59.091995V59.0
V59.61995V59.8
V61.10-V61.121996V61.1
V61.221996V61.21
V62.831996V65.49
V64.41997No previous code assignment
V65.40-V65.45, V65.491994V65.4
V66.71996No previous code assignment
V69.0-V69.31994No previous code assignment
V69.8-V69.91994No previous code assignment
V72.81-V72.851993V72.8
V73.88-V73.891993V73.8
V73.98-V73.991993V73.9
V76.10-V76.121997V76.1
V76.191997V76.1
E854.81995E858.8
E869.41994E869.8
E880.11995E884.9
E884.3-E884.41995E884.2
E906.51995E906.3
E908.0-E908.41995E908
E908.8-E908.91995E908
E909.0-E909.41995E909
E909.8-E909.91995E909
E920.51995E920.4
E922.41997E917.9
E924.21995E924.0
E955.61997E955.9
E967.21996E967.0
E967.31996No previous code assignment
E967.4-E967.81996E967.1
E968.51995E968.8
E968.61997E968.8
E985.61997E985.4


 PROCEDURE CODES

Current code(s) assignmentEffective 
October 1
Previous code(s) assignment
02.96 1992 89.19
03.90 1987 03.99 (Insertion of Catheter)
05.25 1995 39.7
11.75 1989 11.79
11.76 1989 11.62
20.96-20.98 1986 20.95
22.12 1988 22.11
26.12 1988 26.11
29.31 1991 83.02
29.32 1991 29.3
29.33 1991 29.3
29.39 1991 29.3
31.45 1988 31.43-31.44
31.95 1989 31.75
32.01 1989 32.0
32.09 1989 32.0
32.22 1995 32.29, 32.9
32.28 1989 32.29
33.27 1987 33.22 + 33.27
33.28 1987 33.27
33.29 1987 33.28-33.29
33.50 1995 33.5
33.51 1995 33.5
33.52 1995 33.5
33.6 1990 33.5 + 37.5
34.05 1994 34.99
35.84 1988 35.82
35.96 1986 35.03
36.00-36.03 1986 36.0
36.04 1986 39.97
36.05 1987 36.01
36.05 1986 36.01*, 36.02
36.06 1995 36.01, 36.02, 36.03, 36.05
36.09 1986 36.0
36.09 1991 36.00 (Code deleted)
36.17 1996 36.19
37.26-37.27 1988 37.29
37.34 1988 37.33
37.35 1997 37.33
37.65 1995 37.62
37.66 1995 37.62
37.70  (Leads only) 1987 37.70  (Leads/Device)
37.71-37.72  (Leads only) 1987 37.74  (Leads/Device)
37.73  (Leads only) 1987 37.73  (Leads/Device)
37.74  (Leads only) 1987 37.76  (Leads/Device)
37.75  (Leads only) 1987 37.89  (Leads/Device)
37.76  (Leads only) 1987 37.81  (Leads/Device)
37.77  (Leads only) 1987 37.83-37.84  (Leads/Device)
37.78 1987 37.71-37.72
37.79 1987 86.09
37.80-37.87 1992 89.49 (Code deleted, this procedure is included in the code for pacemaker insertion/replacement)
37.80  (Device only) 1987 37.73-37.77  (Leads/Device)
37.81  (Device only) 1987 37.73-37.77  (Leads/Device)
37.82  (Device only) 1987 37.73-37.77  (Leads/Device)
37.83  (Device only) 1987 37.73.37.77  (Leads/Device)
37.85-37.87 1987 37.85
37.89 1987 37.86 +37.89
37.94-37.98 1986 37.99
38.22 1986 38.29
38.44  (Abdominal Aorta Only) 1986 38.44  (Entire Aorta)
38.45  (Thoracic Aorta Added) 1986 38.44-38.45
38.95 1989 38.93
39.28 1991 39.29
39.50 1995 39.59
39.65 1988 39.61
39.66 1990 39.65
39.90 1996 39.50
41.00-41.03 1988 41.0
41.04 1994 99.79
41.05 1997 No previous code assignment
41.06 1997 No previous code assignment
42.25 1988 42.24
42.33 1989 42.32, 42.39
42.33 1990 42.91
43.11 1989 43.1
43.19 1989 43.1, 43.2
43.41 1989 43.41, 43.49
44.21 1986 44.2
44.22 1986 44.99
44.29 1986 44.2
44.43 1989 43.49,45.32
44.44 1989 38.86
44.49 1989 43.0
44.93-44.94 1986 44.99
45.16 1988 45.14 (45.15 before 1987)
45.30 1989 45.31,45.32
45.42 1988 45.41
45.43 1989 45.49
45.75 (Hartmann Resection Added) 1988 48.66 (Code deleted)
45.95 1987 45.93
46.13 1992 46.12 (Code deleted)
46.32 1989 46.39
46.85 1989 46.99
47.01 1996 47.0
47.09 1996 47.0
47.11 1996 47.1
47.19 1996 47.1
48.36 1995 45.42
49.31 1989 49.3
49.39 1989 49.3
51.10 1989 51.97
51.11 1989 51.11,51.97
51.14 1989 51.12
51.15 1989 51.97
51.21 1996 51.22, 51.23
51.22 1991 51.21 (Code deleted), 51.22
51.23 1991 51.22
51.24 1996 51.22, 51.23
51.64 1989 51.69
51.84-51.88 1989 51.97
51.97 1986 52.91,51.99, or 51.82
51.98 1986 51.99
52.13 1989 51.97,52.91
52.14 1989 52.11
52.21 1989 52.2
52.22 1989 52.2
52.84 1996 99.29
52.85 1996 99.29
52.86 1996 99.29
52.93 1989 52.93 +52.91
52.94 1989 52.09
52.97 1989 52.91
52.98 1989 52.91
52.99 1989 52.93,52.94,52.99
54.24 1987 54.23
54.25 1993 54.98
54.51 1996 54.5
54.59 1996 54.5
55.03-55.04 1986 55.02
56.35 1987 45.12
57.17-57.18 1989 57.21
57.22 1989 57.22,57.82
58.31 1990 58.3
58.39 1990 58.3
58.93 1986 57.99
59.03 1996 59.02
59.12 1996 59.11
59.72 1995 59.79
59.96 1986 59.95
60.21 1995 60.2
60.29 1995 60.2
60.95 1991 60.99
64.97 1986 64.95
65.01 1996 65.0
65.09 1996 65.0
65.13 1996 65.12
65.14 1996 65.19
65.23 1996 65.21
65.24 1996 65.22
65.25 1996 65.29
65.31 1996 65.3
65.39 1996 65.3
65.41 1996 65.4
65.49 1996 65.4
65.53 1996 65.51
65.54 1996 65.52
65.63 1996 65.61
65.64 1996 65.62
65.74 1996 65.71
65.75 1996 65.72
65.76 1996 65.73
65.81 1996 65.8
65.89 1996 65.8
66.01 1992 66.0
66.02 1992 66.73
68.15 1987 68.14
68.16 1987 68.13
68.23 1996 68.29
68.51 1996 68.5
68.59 1996 68.5
68.9 1992 68.4
74.3 1992 69.11 (Code deleted)
77.56 1989 77.89, 78.49, 81.18
77.57 1989 77.89, 80.48, 81.18, 83.85
77.58 1989 77.59, 81.18
78.10 1991 78.40
78.11 1991 78.41
78.12 1991 78.42
78.13 1991 78.43
78.14 1991 78.44
78.15 1991 78.45
78.16 1991 78.46
78.17 1991 78.47
78.18 1991 78.48
78.19 1991 78.49
78.20 1991 78.10,78.20,78.30
78.21 (Invalid code) 1991 78.11,78.31
78.22 1991 78.12,78.22,78.32
78.23 1991 78.13,78.23,78.33
78.24 1991 78.14,78.34
78.25 1991 78.15,78.25,78.35
78.27 1991 78.17,78.27,78.37
78.28 1991 78.18,78.38
78.29 1991 78.11,78.16,78.19,78.29,78.39
78.39 1991 78.31
78.90* 1987 78.40
78.91* 1987 78.41
78.92* 1987 78.42
78.93* 1987 78.43
78.94* 1987 78.44
78.95* 1987 78.45
78.96* 1987 78.46
78.97* 1987 78.47
78.98* 1987 78.48
78.99* 1987 78.49
80.50-80.59 1986 80.5
81.03 1989 81.02
81.04-81.05 1989 81.03,81.04,81.05
81.06-81.07 1989 81.06,81.07
81.08 1989 81.06,81.07,81.08
81.09 1989 81.08
81.40 1989 81.69
81.51 1989 81.51,81.59
81.52 1989 81.61,81.62,81.63,81.64
81.53 1989 81.51,81.59,81.61,81.62,81.63,81.64
81.54-81.55 1989 81.41 (Code deleted)
81.56 1989 81.48
81.57 1989 81.31,81.39
81.59 1989 81.39
81.72 1989 81.79
81.73-81.74 1989 81.86 (Code deleted)
81.75 1989 81.87 (Code deleted)
81.79 1989 81.79,81.87
81.80 1989 81.81
81.97 1992 81.59
85.95 1987 85.99
85.96 1987 85.99
86.06 1987 86.09
86.07 1990 86.09
86.27 1986 86.22-86.23
86.28 1988 86.22
86.93 1987 86.89
88.90 1986 88.39
88.91 1986 89.15
88.92 1986 89.39
88.93 1986 89.15
88.94 1986 89.39
88.95 1986 89.29
88.97 1989 88.99
88.98 1989 88.90
88.99 1986 89.39
89.10 1989 89.15
89.17-89.18 1988 89.15
89.19 1989 89.15
89.50 1991 89.54
92.3 1995 01.59,04.07,07.63,07.68
93.90 1988 93.92
94.61-94.69 1989 94.25
96.6 1986 96.35
96.70 1991 93.92  (Code deleted)
96.71 1991 93.92 (Code deleted)
96.72 1991 93.92  (Code deleted)
97.05 1989 51.97
98.51-98.52 1989 59.96  (Code deleted)
98.59 1989 59.96  (Code deleted)
99.00 1995 99.02
99.15 1986 99.29
99.28 1994 99.25
99.71-99.74,99.79* 1988 99.07
99.85 1987 93.35
99.86 1987 93.39
99.88 1988 99.83



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