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Scientific Data Documentation
National Hospital Discharge Survey, 1999
 DSN: CC36.NHDS99

 

Abstract

This material provides documentation for users of the 1999 NHDS Public Use Data File. 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, including data collection and medical coding procedures; population estimates; measurement
errors and sampling errors.

Section II provides technical details about the file.

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 for the calculation of rates; Appendix D provides
unweighted and weighted frequencies for selected variables; and Appendix E shows copies of the
NHDS Medical Abstract Form.


Table Of Contents

Section I. Description of the National Hospital Discharge Survey

Section II. Technical Description of Data File

Section III. Record Layout: Location and Coding of Data Elements

Appendix A Definitions of Certain Terms Used in This Document

Appendix B ICD-9-CM Addenda

Appendix C Population Estimates

Appendix D Unweighted & Weighted Frequencies of Selected NHDS Variables

Appendix E Medical Abstract Form

 

I. Description of The National Hospital Discharge Survey

 Introduction.  This document and its appendices contain information for users of the 1999 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 NCHS website at: http://www.cdc.gov/nchs/about/major/hdasd/listpubs.htm

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 Data File (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. In 1999, the sample consisted of 513 hospitals. Of the 513 hospitals, 26 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 487 in-scope (eligible) hospitals, 458 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 (3). 

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 60 percent of the responding hospitals. The second was an automated method, used for approximately 40 percent of the respondent hospitals, that involved the purchase 
of computerized data files 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 1999, about 30 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 files containing machine-readable medical record data from 
which records were systematically sampled by NCHS.

The Medical Abstract Form (Appendix E) 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 files is the
International Classification of Diseases, 9th Revision, Clinical Modification, or ICD-9-CM (4).

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.

Following conversion of the data on the medical abstract to a computer file and combining it with the 
automated data files, 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 1998 are listed in Appendix B. All coding of the 1999  data is consistent with the ICD-9-CM and the addendum effective October 1, 1998. Information provided      by automated systems for the last three months of 1999 which was coded using the October 1999 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. For more information about the ICD-9-CM, visit:
http://www.cdc.gov/nchs/icd9.htm

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, 1999, which have   been provided by the U.S. Bureau of the Census. Figures are consistent with 
national population estimates in US-99-SIS-7 (U.S. Population Estimates by Age, Sex, Race and Hispanic Origin: 1999) 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 FILE 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 23.2 percent of  the discharges, and 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 Bieler and Williams (6).

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 1999 the estimated number of discharges from short-stay hospitals for children under age 15 with a first-listed diagnosis of asthma (ICD-9-CM code 493) was 190,000. Using the applicable constants from Table 1 for estimates by age produces:

RSE(190,000) = SQRT(.016494 + (223.07202/190,000))

RSE(190,000) = .133

When multiplied by 100, the relative standard error for the estimate of interest becomes 13.3 percent. The standard error of the estimate is obtained by multiplying the relative standard error by the estimate itself:

SE(190,000) = 190,000 * .133 = 25,270

The standard error can be used to generate confidence intervals for statistical testing.  In this example, the    95% confidence interval for the estimate of children under age 15 with a first-listed diagnosis of asthma is:

(190,000 - 2*25,270) <-> (190,000 + 2*25,270)

139460 <-> 240,540

Relative Standard Error for Estimates of Percents

Approximate relative standard errors for estimates of percents may also be calculated from Table 1. The relative standard error for a percent, 100p (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 1999 the estimated number of discharges from short-stay hospitals who were women was 19,384,000. This is 60.3 percent of the estimated 32,132,000 total discharges for that year. Using the applicable constants from Table 1 for estimates by sex produces:

RSE(.603) = SQRT(334.61786 * (1 - .603)/(.603 * 32,132,000))

RSE(.603) = .002618

When multiplied by 100, the relative standard error for the estimate of interest becomes .2618 percent. The standard error is obtained by multiplying the relative standard error by the estimate itself:

SE(.603) = .603* .002618 = .0016

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

(.603 - 2*.0016) <-> (.603 + 2*.0016)

.600 <-> .606

or, equivalently, 60.0% <-> 60.6%


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 1999, the estimated number of days of care for inpatients with a first-listed diagnosis of septicemia (ICD-9-CM code 038) was 2,880,000. The estimated number of discharges for inpatients with a first-listed diagnosis of septicemia was 341,000. The ALOS for inpatients with a first-listed diagnosis of septicemia was 2,880,000/341,000 = 8.4.

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(2,880,000) = .0543
RSE(341,000) = .0509

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

RSE(8.4) = SQRT((.0543)^2 + (.0509)^2)

RSE(8.4) = .0744

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

SE(8.4) = .0744 * 8.4 = .625

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 septicemia is:

(8.4 - 2*.625) <-> (8.4 + 2*.625)

7.2 <-> 9.7

 

Table 1. Parameter values for relative standard errors for National Hospital Discharge Survey aggregate statistics by statistic
type: United States, 1999

 First-Listed DiagnosesDays Of Care All-Listed DiagnosesAll-Listed Procedures
Characteristicababab ab
TOTAL0.001560352.575200.0026041000.949650.003105412.758220.003187357.68835
Sex
Male0.001633359.919410.0029811317.066830.004093363.509350.003464340.74739
Female0.001578334.617860.0026661087.275140.003769326.477220.003684301.79493
AGE GROUP
Under 15 years0.016494223.072020.025039652.941930.018165238.349240.025237253.97288
15-44 years0.001763325.127680.0033081033.447790.001589343.089950.002402305.64621
45-64 years0.002044377.511240.0030971341.599770.002337337.004500.004366273.42803
65 yrs and over0.002189338.472090.0027292033.882180.002026346.437980.003618341.62920
REGION
Northeast0.005121193.546150.010383269.396820.007518197.337090.007950230.43315
Midwest0.009636233.354850.013644402.061320.011474211.105200.012990172.54412
South0.003298353.039170.005486920.653270.003989367.901900.008102286.55150
West0.004267367.675680.008367937.578020.004568435.544430.004604393.92609
RACE 
White0.003218378.461180.0047911075.689250.005559360.329010.005553380.84500
Black0.005020234.730770.008239762.362740.006288222.528920.005923221.28609
All other0.020995206.991870.035926392.148960.017983259.865840.022261198.53245
Races not stated0.018749207.207560.021876500.992870.020816253.877080.020675190.69041
ESOP
Worker's comp0.006348300.780760.015928705.379340.013841209.668590.011021300.33297
Medicare0.002403359.968510.0028312254.199750.002217378.711250.004039346.82800
Medicaid0.005705286.427270.008866984.246420.004944291.077090.006874250.49644
Other govt payments0.010600418.698240.0222861401.287150.014075397.239820.015924278.79531
Blue Cross/Blue Sheild0.004729325.286070.008610858.578230.005580274.676710.007490242.45169
HMO/PPO0.004863254.389880.007955653.224540.004699302.205960.008370243.86402
Other Private0.006475294.907960.010133771.302940.007743256.535310.008985245.38001
Self Pay0.004571261.646690.008564988.398770.005208255.864210.007486231.63889
No charge0.142475189.605760.130227657.691150.14091144.566610.202030-154.27572
Other0.036444123.221390.043781583.405800.031121150.790870.047181107.96191
Not Stated0.031556398.017510.0415541243.123400.033433386.286580.038255333.15455

Users of NHDS data are cautioned that computed estimates based on fewer than 30 unweighted records are not reliable and should not be reported. Because these estimates are based on so few data points, they are excluded from the calculation of the generalized variance curves. Thus, application of generalized variance curves is appropriate only for estimates based on at least 30 records.

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 for presenting 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 in-scope. 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 1999 NHDS, 81.2 percent
of the 458 responding hospitals provided data for all twelve months, and 95.9 percent provided at least nine months of data.

How to Use the Data File.  The NHDS records are weighted to allow inflation to national or regional
estimates. The weight applied to each record is found in 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 (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. These may be used as a cross-check when analyzing NHDS data.

Diagnosis-Related Groups (DRGs).  Many users of the NHDS data have expressed an interest in converting
the medical 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 NHDS data should be directed to:

Jennifer R. 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
Surgery Data 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 Dennison C, Pokras R. Plan and Operation of the National Hospital Discharge Survey.  National
  Center for
Health Statistics. Vital Health Stat 1(39). 2000. http://www.cdc.gov/nchs/data/sr1_39.pdf

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 Simmons WR, Schnack GA. Development of the Design of the NCHS Hospital Discharge Survey. National 
  Center for Health Statistics. Vital Health Stat 2(39). 1977.

4 International Classification of Diseases, 9 th Revision, Clinical Modification, 6 th edition. U.S. Department of  
  Health and Humans Services, National Center for Health Statistics, Health Care Financing Administration.
 
  1998.

5 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.

6 Bieler GS, Williams RL. Analyzing Survey Data Using SUDAAN Release 7.5. Research Triangle Institute:
  Research Triangle Park, N.C. 1997.


II. Technical Description Of Data File

Data Set NameNHDS99PU.TXT
Record Length85
Number of Records300,460

 

III. Record Layout: Location and Coding of Data Elements

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

 Item               Number of
 Number  Location   Positions   Item description     Code description

  1        1-2        2         Survey Year          99

  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,        If units=years: 00-99*  
                                months, or days      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

  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       0=Less than 1 day
                                flag                 1=One day or more

  12       18         1         Geographic region    1=Northeast
                                                     2=Midwest
                                                     3=South
                                                     4=West

  13       19         1         Number of beds,      1=6-99
                                recode               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     19
                                of survey year

  17       28-32      5         Diagnosis code #1    *

  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   01=Worker's comp
                                source of payment    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   Same coding as item 28 above
                                source of payment 

 30        83-85      3         Diagnosis-Related    Grouper version 16.0
                                Groups (DRG)

*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 (4).

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

NORTHEASTMIDWESTSOUTHWEST
MaineMichiganDelawareMontana
New HampshireOhioMarylandIdaho
VermontIllinoisDistrict of ColumbiaWyoming
MassachusettsIndianaVirginiaColorado
ConnecticutWisconsinWest VirginiaNew Mexico
Rhode IslandMinnesotaNorth CarolinaArizona
New YorkIowaSouth CarolinaUtah
New JerseyMissouriGeorgiaNevada
PennsylvaniaNorth DakotaFloridaWashington
South DakotaKentuckyOregon
NebraskaTennesseeCalifornia
KansasAlabamaHawaii
MississippiAlaska
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 1999.

As described earlier in this document, the 1999 NHDS involved two data collection modes: manual and automated abstract services. All data collected manually were coded using the third edition of the ICD-9- CM, which includes the addenda for 1986 through 1998. Data collected via automated abstract services were coded using two different ICD-9-CM revisions. For the first 9 months of 1999, the ICD-9-CM including the addendum of October 1, 1986-98 was used; for the last 3 months the October 1999 addendum was used.

Therefore, data provided by automated systems for the last three months of 1999 was converted back to the code assignment under the October 1998 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 to show 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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