CMS Target Areas in PEPPER version 13 (released January 2006).

Numerator: count of discharges with length of stay less than or equal to one day excluding patient status of 20 (expired), 07 (left against medical advice), or 02 (discharged/transferred to a short-term general hospital for inpatient care)

Denominator: count of all discharges excluding patient status 02

Numerator: count of discharges with DRG equal to 127 (heart failure and shock) with length of stay less than or equal to one day excluding patient status of 20 (expired), 07 (left against medical advice), or 02 (discharged/transferred to a short-term general hospital for inpatient care)

Denominator: count of all DRG 127 discharges

Numerator: count of discharges with DRG equal to 143 (chest pain) with length of stay less than or equal to one day excluding patient status of 20 (expired), 07 (left against medical advice), or 02 (discharged/transferred to a short-term general hospital for inpatient care)

Denominator: count of all DRG 143 discharges

Numerator: count of discharges with DRG equal to 182 (esophagitis, gastroenteritis and miscellaneous digestive disorders age > 17 with complication or comorbidity) or 183 (esophagitis, gastroenteritis and miscellaneous digestive disorders age > 17 without complication or comorbidity) with length of stay less than or equal to one day excluding patient status of 20 (expired), 07 (left against medical advice), or 02 (discharged/transferred to a short-term general hospital for inpatient care)

Denominator: count of discharges with DRG equal to 182 or 183

Numerator: count of discharges with DRG equal to 296 (nutritional and miscellaneous metabolic disorders age > 17 with complication or comorbidity) or 297 (nutritional and miscellaneous metabolic disorders age > 17 without complication or comorbidity) with length of stay less than or equal to one day excluding patient status of 20 (expired), 07 (left against medical advice), or 02 (discharged/transferred to a short-term general hospital for inpatient care)

Denominator: count of discharges with DRG equal to 296 or 297

Numerator: count of discharges with DRG equal to 014 (intracranial hemorrhage and stroke with infarct)

Denominator: count of discharges with DRG equal to 014, 015 (nonspecific CVA and precerebral occlusion without infarct), or 524 (transient ischemia)IMPORTANT: DRGs 014 and 015 were redefined and DRG 524 was added effective with discharges starting October 1, 2002. This impacts the comparability of the proportions reported these DRGs. Trending cannot be conducted for these DRGs using fiscal year 2003 data. Hospitals are recommended to evaluate the fiscal year 2003 data as a stand-alone time period.

Numerator: count of discharges with DRG equal to 079 (respiratory infections and inflammations age > 17 with complication or comorbidity)

Denominator: count of discharges with DRG equal to 079, 080 (respiratory infections and inflammations age > 17 without complication or comorbidity), 089 (simple pneumonia and pleurisy age > 17 with complication or comorbidity), or 090 (simple pneumonia and pleurisy age > 17 without complication or comorbidity)

Numerator: count of discharges with DRG equal to 243 (medical back problems).

Denominator: count of all discharges

Numerator: count of discharges with DRG equal to 416 (septicemia age > 17)

Denominator: count of discharges with DRG equal to 416, 320 (kidney and urinary tract infections age > 17 with complication or comorbidity), or 321 (kidney and urinary tract infections age > 17 without complication or comorbidity)

Numerator: count of index (first) admissions for which a readmission occurred within seven days to the same hospital or to another short-term acute care PPS hospital for the same beneficiary (identified using the Health Insurance Claim number); patient status of the index admission is not equal to 02 (discharged/transferred to a short-term general hospital for inpatient care)

Denominator: count of all discharges

Numerator: count of discharges with DRG equal to 089 (Simple Pneumonia and Pleurisy, age > 17 with complication or comorbidity).

Denominator: count of discharges with DRG equal to DRGs 089, 090 (Simple Pneumonia and Pleurisy, age > 17 without complication or comorbidity), or 088(Chronic Obstructive Pulmonary Disease)

Numerator: count of discharges for medical DRGs with a CC, excluding DRGs 079/089

Denominator: count of discharges for all medical DRG pairs, excluding DRGs 079/080/089/090

Numerator: count of discharges to a SNF with a three-day length of stay

Denominator: count of all discharges to a SNF (identified by patient status code of 03 (discharged or transferred to a SNF) or 61 (discharged or transferred to a swing bed))