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Ask ACDIS: Unpacking SOI/ROM scores in the APR-DRG system
Q: What is difference between the severity of illness (SOI)/risk of mortality (ROM) in the APR-DRG arena? For example, DRG 280 with APR 190, 4/4, and the individual code SOI/ROM.
Let’s say you have a patient with a ST-elevation myocardial infarction (STEMI), acute respiratory failure on mechanical ventilation, diabetes mellitus (DM) with hyperosmolar hyperglycemic state, shock, etc. and the DRG is DRG 280 (MI) with 4/4 for SOI/ROM. The patient is unresponsive and was comatose with a Glasgow Coma Scale score of 3 at the transferring facility. Your facility receives the patient to do a heart catheterization for the STEMI.
You are already at a 4/4, but you wonder if the patient has Type 1 DM with ketoacidosis with coma instead of Type 1 DM with ketoacidosis without coma. The individual SOI/ROM for Type 1 DM with ketoacidosis with coma is 4/3; without coma is 3/3. Why is there a difference? Should I query?
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