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The EDC Analyzer™ reviews all reason for visit diagnosis codes and assigns a Proportional Standard Cost Allocation (PSCA) and associated standard weight to each code based on the age and sex* of the patient. If multiple PSCAs are assigned to a claim, the EDC Analyzer™ takes the highest PSCA found. There are five possible PSCAs corresponding to the five ED visit levels:
PSCA | Description |
---|---|
1 (lowest weight) | Presenting problem is self-limited or minor |
2 | Presenting problem is low to moderate severity |
3 | Presenting problem is moderate severity |
4 | Presenting problem is high severity, requiring urgent evaluation |
5 (highest weight) | Presenting problem is high severity, posing an immediate, significant threat to physiological function |
Standard weights were calculated by analyzing the typical amount of facility resources utilized for each presenting problem which includes the following:
Presenting Problem | Diagnosis Code | Age Range | Sex* | Standard Weight** |
---|---|---|---|---|
Blood pressure check | Z01.30 | > 2 | M & F | *** |
Weakness | R53.1 | > 2 | M & F | **** |
Seizure: pregnant | O15.9 | 7 – 54 | F | **** |
Fever | R50.9 | 2 – 74 | M & F | *** |
Fever | R50.9 | 75+ | M & F | *** |
Wheezing | R06.2 | 2 – 11 | M & F | *** |
Wheezing | R06.2 | 12+ | M & F | **** |