IP - CA.1.intracardiac

CM Codes

Data Overview

6337 total codes in komodo_rii; 163 retained after n_claims > 500 filter.

CMS severity	n codes
No CC/MCC	112
CC	39
MCC	12

PCA Analysis

PC1 explains 50.3% of variance; PC1+PC2 together explain 62.2%.

Tier Clustering (k=3)

Tier Summary

tier	n_codes	n_claims	n distinct rev codes	length of stay	organ system count	relative claim charge	n imaging lines	work rvu	n j code lines	icu
1	122.000	552888.000	14.496	2.967	4.294	1.022	0.226	0.490	0.321	0.356
2	28.000	50316.000	17.671	5.719	4.526	1.210	0.462	0.582	0.446	0.494
3	13.000	15649.000	20.113	7.729	4.945	1.396	0.593	0.759	0.578	0.612

CMS Severity × intensity Tier

cms_severity	Tier 1	Tier 2	Tier 3	All
CC	27	8	4	39
MCC	1	5	6	12
No CC/MCC	94	15	3	112
All	122	28	13	163

Feature Analysis

Feature Correlation

Feature Audit

	pc1_loading	r_with_volume	r_with_severity
avg_n_distinct_rev_codes	0.367	-0.331	0.402
avg_length_of_stay	0.360	-0.299	0.422
rate_icu	0.357	-0.298	0.382
avg_relative_claim_charge	0.347	-0.222	0.350
avg_n_imaging_lines	0.340	-0.341	0.343
rate_mechanical_ventilation	0.326	-0.196	0.371
avg_n_j_code_lines	0.276	-0.175	0.354
rate_transfusion	0.261	-0.344	0.202
avg_n_distinct_hcps	0.248	-0.356	0.061
avg_work_rvu	0.173	-0.206	0.241
avg_organ_system_count	0.132	-0.301	-0.111
rate_multiple_or_days	0.086	0.045	0.044
rate_dialysis	0.059	-0.138	0.417
rate_or	-0.035	0.060	-0.221

Top 6 Tier-Discriminating Features

Bottom 6 Tier-Discriminating Features

Score Validation

Misclassification Audit (N=10 samples)

Over-tiered: Tier 3, No CC/MCC (3 codes)

code	code_description	cms_severity	intensity_score	tier	n_claims	key_drivers
E8720	Acidosis, unspecified	No CC/MCC	5.606	3	1755	n distinct rev codes (+0.78), n imaging lines (+0.77), length of stay (+0.69)
E8770	Fluid overload, unspecified	No CC/MCC	5.444	3	533	work rvu (+0.76), n distinct hcps (+0.76), transfusion (+0.75)
K5900	Constipation, unspecified	No CC/MCC	4.667	3	809	n distinct hcps (+0.63), length of stay (+0.62), n distinct rev codes (+0.61)

Under-tiered: Tier 1, MCC (1 codes)

code	code_description	cms_severity	intensity_score	tier	n_claims	key_drivers
N186	End stage renal disease	MCC	0.629	1	1958	dialysis (+0.40), transfusion (+0.19), n distinct hcps (-0.17)

Top Codes by Tier

Tier 1 (n=122 codes)

code	Description	CMS severity	Score	N claims	Key drivers
N186	End stage renal disease	MCC	0.629	1958	dialysis (+0.40), transfusion (+0.19), n distinct hcps (-0.17)
I452	Bifascicular block	CC	0.560	685	n distinct hcps (+0.49), n j code lines (-0.27), icu (+0.25)
I421	Obstructive hypertrophic cardiomyopathy	CC	0.502	645	work rvu (+1.05), n j code lines (+0.71), relative claim charge (-0.64)
I456	Pre-excitation syndrome	No CC/MCC	0.344	553	n j code lines (+0.51), organ system count (-0.33), n distinct hcps (+0.28)
I471	None	CC	0.329	2978	n distinct hcps (+0.36), relative claim charge (-0.22), n imaging lines (+0.17)
I420	Dilated cardiomyopathy	CC	0.319	2545	icu (+0.16), transfusion (-0.14), length of stay (+0.12)
I341	Nonrheumatic mitral (valve) prolapse	No CC/MCC	0.284	561	transfusion (+0.41), n distinct hcps (+0.32), multiple or days (+0.24)
I493	Ventricular premature depolarization	No CC/MCC	0.256	3099	n j code lines (+0.21), n distinct hcps (+0.18), organ system count (-0.13)
F329	Major depressive disorder, single episode, unspecified	No CC/MCC	0.254	531	work rvu (+0.31), organ system count (+0.18), relative claim charge (-0.14)
I440	Atrioventricular block, first degree	No CC/MCC	0.236	1271	n distinct hcps (+0.44), work rvu (+0.21), mechanical ventilation (-0.14)

Tier 2 (n=28 codes)

code	Description	CMS severity	Score	N claims	Key drivers
I214	Non-ST elevation (NSTEMI) myocardial infarction	MCC	4.386	833	n distinct rev codes (+0.73), icu (+0.69), relative claim charge (+0.64)
J441	Chronic obstructive pulmonary disease with (acute) exacerbation	CC	4.043	760	length of stay (+0.83), n distinct rev codes (+0.81), n imaging lines (+0.73)
D72829	Elevated white blood cell count, unspecified	No CC/MCC	3.811	1279	icu (+0.56), relative claim charge (+0.54), n j code lines (+0.50)
E871	Hypo-osmolality and hyponatremia	CC	3.643	2754	length of stay (+0.71), n distinct rev codes (+0.64), n imaging lines (+0.58)
E875	Hyperkalemia	No CC/MCC	3.595	1180	length of stay (+0.55), n distinct rev codes (+0.53), n distinct hcps (+0.47)
I5023	Acute on chronic systolic (congestive) heart failure	MCC	3.567	3377	length of stay (+0.72), n distinct rev codes (+0.61), icu (+0.51)
N390	Urinary tract infection, site not specified	CC	3.497	1016	length of stay (+0.77), n distinct rev codes (+0.71), n imaging lines (+0.70)
I5021	Acute systolic (congestive) heart failure	MCC	3.345	809	n j code lines (+0.90), n imaging lines (+0.71), n distinct rev codes (+0.58)
N179	Acute kidney failure, unspecified	CC	3.209	6600	length of stay (+0.58), n distinct rev codes (+0.54), n imaging lines (+0.48)
I4729	Other ventricular tachycardia	No CC/MCC	3.121	1371	icu (+0.53), relative claim charge (+0.47), length of stay (+0.44)

Tier 3 (n=13 codes)

code	Description	CMS severity	Score	N claims	Key drivers
N170	Acute kidney failure with tubular necrosis	MCC	11.772	529	mechanical ventilation (+1.70), relative claim charge (+1.64), length of stay (+1.54)
J9601	Acute respiratory failure with hypoxia	MCC	7.782	3048	mechanical ventilation (+1.70), relative claim charge (+1.01), n distinct rev codes (+1.00)
J90	Pleural effusion, not elsewhere classified	CC	6.941	713	relative claim charge (+1.37), n distinct rev codes (+0.91), n imaging lines (+0.82)
D62	Acute posthemorrhagic anemia	CC	6.829	2089	transfusion (+1.85), icu (+0.89), n distinct rev codes (+0.86)
J9811	Atelectasis	CC	6.795	1146	icu (+0.93), n distinct rev codes (+0.91), transfusion (+0.91)
J9621	Acute and chronic respiratory failure with hypoxia	MCC	6.792	992	mechanical ventilation (+1.29), length of stay (+1.18), n distinct rev codes (+1.05)
J189	Pneumonia, unspecified organism	MCC	5.961	1052	n imaging lines (+1.24), n distinct rev codes (+1.01), length of stay (+0.97)
I314	Cardiac tamponade	CC	5.651	551	mechanical ventilation (+1.23), icu (+1.20), transfusion (+1.18)
E8720	Acidosis, unspecified	No CC/MCC	5.606	1755	n distinct rev codes (+0.78), n imaging lines (+0.77), length of stay (+0.69)
E8770	Fluid overload, unspecified	No CC/MCC	5.444	533	work rvu (+0.76), n distinct hcps (+0.76), transfusion (+0.75)

Key Driver Frequency

feature	count	pct
n distinct rev codes	76	46.600
length of stay	74	45.400
icu	67	41.100
n imaging lines	50	30.700
n j code lines	44	27.000
n distinct hcps	43	26.400
relative claim charge	42	25.800
transfusion	26	16.000
mechanical ventilation	23	14.100
organ system count	17	10.400
work rvu	16	9.800
multiple or days	7	4.300
dialysis	4	2.500

PCS Codes

Data Overview

1783 total codes in komodo_rii; 42 retained after n_claims > 500 filter.

PCA Analysis

PC1 explains 54.0% of variance; PC1+PC2 together explain 68.2%.

Tier Clustering (k=3)

Tier Summary

tier	n_codes	n_claims	n distinct rev codes	length of stay	organ system count	work rvu	relative claim charge	icu	transfusion	n j code lines
1	15.000	118504.000	14.382	2.508	3.479	0.429	1.095	0.339	0.037	0.355
2	21.000	98576.000	17.260	5.110	4.127	0.581	1.228	0.500	0.079	0.472
3	6.000	5101.000	22.355	8.975	5.070	1.072	1.513	0.750	0.415	0.756

Feature Analysis

Feature Correlation

Feature Audit

	pc1_loading	r_with_volume
avg_n_distinct_rev_codes	0.356	-0.492
avg_length_of_stay	0.349	-0.388
rate_icu	0.325	-0.451
avg_organ_system_count	0.323	-0.382
avg_relative_claim_charge	0.290	-0.404
avg_n_imaging_lines	0.287	-0.244
avg_work_rvu	0.272	-0.231
avg_n_j_code_lines	0.262	-0.309
rate_mechanical_ventilation	0.247	-0.449
rate_transfusion	0.243	-0.334
rate_multiple_or_days	0.228	-0.060
avg_n_distinct_hcps	0.200	-0.393
rate_or	0.126	-0.238
rate_dialysis	0.070	-0.284

Top 6 Tier-Discriminating Features

Bottom 6 Tier-Discriminating Features

Score Validation

Top Codes by Tier

Tier 1 (n=15 codes)

code	Description	Score	N claims	Key drivers
02U53JZ	SUPPLEMENT ATRIAL SEPTUM WITH SYNTHETIC SUBSTITUTE, PERCUTANEOUS APPROACH	-1.169	978	organ system count (-0.44), n imaging lines (+0.23), work rvu (+0.19)
B24BZZZ	ULTRASONOGRAPHY OF HEART WITH AORTA	-1.484	2938	n distinct rev codes (-0.28), icu (-0.24), length of stay (-0.24)
02573ZK	DESTRUCTION OF LEFT ATRIAL APPENDAGE, PERCUTANEOUS APPROACH	-1.587	573	n distinct hcps (-0.29), n distinct rev codes (-0.24), organ system count (-0.20)
B246ZZZ	ULTRASONOGRAPHY OF RIGHT AND LEFT HEART	-1.600	2469	n distinct rev codes (-0.28), icu (-0.26), length of stay (-0.22)
4A023N7	MEASUREMENT OF CARDIAC SAMPLING AND PRESSURE, LEFT HEART, PERCUTANEOUS APPROACH	-1.600	5328	multiple or days (-0.18), relative claim charge (-0.18), organ system count (-0.17)
02583ZF	None	-1.876	3470	relative claim charge (+0.49), organ system count (-0.42), n distinct rev codes (-0.36)
B2151ZZ	FLUOROSCOPY OF LEFT HEART USING LOW OSMOLAR CONTRAST	-2.088	3261	length of stay (-0.30), relative claim charge (-0.27), n distinct rev codes (-0.26)
B246ZZ3	ULTRASONOGRAPHY OF RIGHT AND LEFT HEART, INTRAVASCULAR	-2.285	658	n distinct rev codes (-0.35), length of stay (-0.26), icu (-0.24)
B24CZZ4	ULTRASONOGRAPHY OF PERICARDIUM, TRANSESOPHAGEAL	-2.632	1167	length of stay (-0.37), n j code lines (-0.34), work rvu (-0.32)
B245ZZZ	ULTRASONOGRAPHY OF LEFT HEART	-2.931	1314	n distinct rev codes (-0.44), length of stay (-0.38), organ system count (-0.37)

Tier 2 (n=21 codes)

code	Description	Score	N claims	Key drivers
4A023N6	MEASUREMENT OF CARDIAC SAMPLING AND PRESSURE, RIGHT HEART, PERCUTANEOUS APPROACH	2.268	1117	length of stay (+0.57), n imaging lines (+0.38), n distinct rev codes (+0.34)
5A09357	ASSISTANCE WITH RESPIRATORY VENTILATION, LESS THAN 24 CONSECUTIVE HOURS, CONTINUOUS POSITIVE AIRWAY PRESSURE	1.654	1467	organ system count (+0.44), multiple or days (+0.30), length of stay (+0.29)
0W9D30Z	DRAINAGE OF PERICARDIAL CAVITY WITH DRAINAGE DEVICE, PERCUTANEOUS APPROACH	1.453	527	icu (+0.48), transfusion (+0.23), n distinct rev codes (+0.21)
5A1D70Z	PERFORMANCE OF URINARY FILTRATION, INTERMITTENT, LESS THAN 6 HOURS PER DAY	1.170	1045	organ system count (+0.53), dialysis (+0.44), length of stay (+0.19)
4A133B1	MONITORING OF ARTERIAL PRESSURE, PERIPHERAL, PERCUTANEOUS APPROACH	1.058	616	relative claim charge (+0.47), n j code lines (+0.45), work rvu (+0.24)
3E033XZ	INTRODUCTION OF VASOPRESSOR INTO PERIPHERAL VEIN, PERCUTANEOUS APPROACH	0.844	938	n imaging lines (+0.24), organ system count (+0.19), n distinct rev codes (+0.16)
5A1223Z	PERFORMANCE OF CARDIAC PACING, CONTINUOUS	0.558	512	icu (+0.40), n distinct hcps (+0.26), work rvu (-0.19)
0JH632Z	INSERTION OF MONITORING DEVICE INTO CHEST SUBCUTANEOUS TISSUE AND FASCIA, PERCUTANEOUS APPROACH	0.555	741	n imaging lines (+0.60), multiple or days (+0.53), work rvu (+0.27)
4B02XTZ	MEASUREMENT OF CARDIAC DEFIBRILLATOR, EXTERNAL APPROACH	0.261	684	length of stay (+0.25), n distinct hcps (+0.12), or (-0.11)
02HK3JZ	INSERTION OF PACEMAKER LEAD INTO RIGHT VENTRICLE, PERCUTANEOUS APPROACH	0.230	530	n distinct hcps (+0.82), organ system count (+0.40), n j code lines (-0.35)

Tier 3 (n=6 codes)

code	Description	Score	N claims	Key drivers
0BH17EZ	INSERTION OF ENDOTRACHEAL AIRWAY INTO TRACHEA, VIA NATURAL OR ARTIFICIAL OPENING	8.804	600	mechanical ventilation (+1.52), work rvu (+1.04), relative claim charge (+1.03)
02HV33Z	INSERTION OF INFUSION DEVICE INTO SUPERIOR VENA CAVA, PERCUTANEOUS APPROACH	6.594	1068	length of stay (+0.88), relative claim charge (+0.82), n distinct rev codes (+0.76)
02L70CK	OCCLUSION OF LEFT ATRIAL APPENDAGE WITH EXTRALUMINAL DEVICE, OPEN APPROACH	5.174	1115	icu (+0.76), n distinct rev codes (+0.69), multiple or days (+0.67)
5A1221Z	PERFORMANCE OF CARDIAC OUTPUT, CONTINUOUS	5.092	939	n distinct rev codes (+0.75), icu (+0.74), organ system count (+0.73)
3E043XZ	INTRODUCTION OF VASOPRESSOR INTO CENTRAL VEIN, PERCUTANEOUS APPROACH	3.543	501	n distinct rev codes (+0.49), length of stay (+0.46), icu (+0.46)
30233N1	TRANSFUSION OF NONAUTOLOGOUS RED BLOOD CELLS INTO PERIPHERAL VEIN, PERCUTANEOUS APPROACH	3.403	878	transfusion (+1.14), n distinct rev codes (+0.57), organ system count (+0.57)

Key Driver Frequency

feature	count	pct
n distinct rev codes	23	54.800
length of stay	16	38.100
organ system count	13	31.000
icu	12	28.600
work rvu	10	23.800
multiple or days	8	19.000
n imaging lines	8	19.000
or	7	16.700
relative claim charge	7	16.700
n j code lines	7	16.700
transfusion	7	16.700
n distinct hcps	6	14.300
dialysis	1	2.400
mechanical ventilation	1	2.400