Understanding the High Prevalence of Low-Prevalence Chronic Disease Combinations: Databases and Methods for Research. Axiomedics Research, Inc. Grouper System

09/20/2013

Dyani Diagnosis Grouper
Sponsorship: Axiomedics Research, Inc.
Description: The Dyani Diagnosis Grouper is a classification system that groups ICD-9 codes into a small set of clinically and financially homogenous categories with no appreciable loss of clinical specificity. This grouping system uses medical transaction data from the span of a worker’s compensation claim history.1
Purpose/Use: The Dyani Diagnosis Grouper is used to perform case mix adjustment for the workers’ compensation market.
Coding Family: International Classification of Diseases, Ninth Revision (ICD- 9)
Grouping Methodology:

The Dyani Diagnosis Grouper uses a proprietary algorithm to identify unique ICD-9 codes (primary, secondary and tertiary diagnoses) in medical transaction data and rank them according to incidence, timing, costs and services. There are three guiding principles to this algorithm:

1. A focus on ICD-9 codes that are specific.

2. Assigning claims to one of a manageable number of diagnosis categories that are both clinically and financially homogenous.

3. Not using clinical treatment decisions (such as the use of surgery) to differentiate among diagnosis categories.

The Dyani Diagnosis Grouper crosswalks primary diagnosis codes to a specific diagnosis category, developed specifically for workers’ compensation data. This process groups thousands of ICD-9 codes into several hundred workers’ compensation diagnosis categories.2

In this grouping system, ICD-9 codes are also assigned to five different criteria: major diagnostic categories, minor diagnostic categories, body systems, anatomy (location) and detail (anything diagnosis code codifies as pertinent additional information).

Level of Diagnosis Aggregation: Diagnosis codes can be grouped into 200-300 categories depending on the axis (criteria) being examined.
Number of Codes Included: Proprietary - Not Available
Number of Codes Excluded: Proprietary - Not Available
Methodological Considerations: The Dyani Diagnosis Grouper is sensitive to differences between occupational injuries. It is the only grouping system available for the workers’ compensation market and was not originally designed for group health plans. New ICD-9 codes haven’t been added to this system since 2010, but could be at the request of the owner.
Related Data Sources: Claims data
Used in Disease Complexity Research: No

References:

1 Axiomedics Research Inc. Dyani Diagnosis Grouper. 2013. http://www.axiomedics.com/grouper.htm

2 Axiomedics Research Inc. PUMA Provider Utilization Management and Analysis. 2013. http://science-mom.com/axiomedicsresearch.com/images/puma%20overview%202012.pdf

 

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