Exploring Episode-Based Approaches for Medicare Performance Measurement, Accountability and Payment Final Report. Appendix C. Episodes Related to Conditions of Focus


Condition ETGs (version 6.0) MEGs
Acute myocardial infarction 386500: Ischemic heart disease 11: Acute myocardial infarction
Bacterial pneumonia 437400: Bacterial lung infections 510: Pneumonia: bacterial
Breast cancer (limited to women) 635600: Malignant neoplasm of breast 212: Neoplasm, malignant: breast, female

427: Encounter for Chemotherapy

431: Encounter for Radiation Therapy

Cerebrovascular disease 316000: Cerebral vascular accident 395: Cerebrovascular disease, chronic maintenance

396: Cerebrovascular disease with TIA

397: Cerebrovascular disease with stroke

Chronic obstructive pulmonary disease- -   439300: Chronic obstructive pulmonary disease (COPD) 500: Chronic obstructive pulmonary disease
Congestive heart failure 387100: Heart failure, diastolic

386800: Congestive heart failure

9: Congestive heart failure
Diabetes 163000: Diabetes 49: Diabetes mellitus type 1 Maintenance 50: Diabetes mellitus type 2 and hyperglycemic states maintenance

51: Diabetes mellitus with complications

Hip fracture 712903: Open fracture or dislocation - thigh, hip & pelvis

713103: Closed fracture or dislocation - thigh, hip & pelvis

360: Fracture, dislocation or sprain: hip or pelvis 348: Fracture:  Femur, Head or Neck
Low back pain 711908: Major joint inflammation, back

712208: Joint degeneration, localized, back

713109: Closed fracture or dislocation of trunk

714608: Minor orthopedic trauma - back

714908: Other minor orthopedic disorders - back

715108: Orthopedic deformity - back

719908: Orthopedic signs & symptoms - back

365: Herniated intervertebral disc

374: Osteoarthritis

389: Other arthropathies, bone and joint disorders

391: Other spinal and back disorders

405: Injury: spine and spinal cord

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