OP - CA.0.rhythm_monitor

CM Codes

Data Overview

4038 total codes in komodo_rii; 76 retained after n_claims > 500 filter.

CMS severity	n codes
No CC/MCC	64
CC	11
MCC	1

PCA Analysis

PC1 explains 31.1% of variance; PC1+PC2 together explain 44.6%.

Tier Clustering (k=4)

Tier Summary

tier	n_codes	n_claims	work rvu	organ system count	n j code lines	n distinct rev codes	relative claim charge	or	n distinct hcps	n imaging lines
1	32.000	147442.000	2.073	3.361	1.028	4.335	1.029	0.418	0.710	0.004
2	29.000	70222.000	2.305	3.074	1.187	4.459	1.047	0.399	0.705	0.008
3	11.000	10405.000	2.765	2.395	1.309	4.498	1.137	0.371	0.704	0.006
4	4.000	5744.000	3.397	2.222	1.695	4.798	1.204	0.334	0.726	0.007

CMS Severity × intensity Tier

cms_severity	Tier 1	Tier 2	Tier 3	Tier 4	All
CC	2	4	3	2	11
MCC	1	0	0	0	1
No CC/MCC	29	25	8	2	64
All	32	29	11	4	76

Feature Analysis

Feature Correlation

Feature Audit

	pc1_loading	r_with_volume	r_with_severity
avg_work_rvu	0.505	-0.140	0.182
avg_n_j_code_lines	0.460	-0.269	0.033
avg_relative_claim_charge	0.436	-0.124	0.314
avg_n_distinct_rev_codes	0.363	-0.365	-0.081
avg_n_imaging_lines	0.058	-0.058	0.006
avg_n_distinct_hcps	0.018	-0.065	-0.144
avg_length_of_stay	-0.000	nan	nan
rate_mechanical_ventilation	0.000	nan	nan
rate_multiple_or_days	-0.000	nan	nan
rate_dialysis	-0.002	0.115	-0.115
rate_icu	-0.038	0.260	0.225
rate_transfusion	-0.068	0.337	0.062
avg_organ_system_count	-0.270	-0.186	-0.296
rate_or	-0.359	0.078	-0.040

Top 6 Tier-Discriminating Features

Bottom 6 Tier-Discriminating Features

Score Validation

Misclassification Audit (N=10 samples)

Over-tiered: Tier 4, No CC/MCC (2 codes)

code	code_description	cms_severity	intensity_score	tier	n_claims	key_drivers
I4729	Other ventricular tachycardia	No CC/MCC	8.219	4	1734	n j code lines (+2.15), work rvu (+1.96), n distinct rev codes (+1.30)
I4720	Ventricular tachycardia, unspecified	No CC/MCC	4.135	4	2451	work rvu (+1.36), relative claim charge (+0.95), n j code lines (+0.91)

Under-tiered: Tier 1, MCC (1 codes)

code	code_description	cms_severity	intensity_score	tier	n_claims	key_drivers
I639	Cerebral infarction, unspecified	MCC	-2.008	1	9775	n j code lines (-0.92), n distinct rev codes (-0.81), work rvu (-0.75)

Top Codes by Tier

Tier 1 (n=32 codes)

code	Description	CMS severity	Score	N claims	Key drivers
E119	Type 2 diabetes mellitus without complications	No CC/MCC	-0.727	8920	work rvu (-0.32), relative claim charge (-0.27), n j code lines (-0.22)
E1122	Type 2 diabetes mellitus with diabetic chronic kidney disease	No CC/MCC	-0.752	2212	organ system count (-0.37), n distinct rev codes (+0.28), n j code lines (-0.24)
I499	Cardiac arrhythmia, unspecified	No CC/MCC	-0.822	1087	or (-0.68), organ system count (+0.33), work rvu (-0.28)
I4892	Unspecified atrial flutter	CC	-0.891	2210	n distinct rev codes (-0.37), organ system count (+0.27), icu (-0.23)
N189	Chronic kidney disease, unspecified	No CC/MCC	-0.892	1536	work rvu (-0.31), organ system count (-0.27), or (-0.25)
J45909	Unspecified asthma, uncomplicated	No CC/MCC	-0.897	2564	relative claim charge (-0.44), n distinct rev codes (-0.33), organ system count (-0.30)
I491	Atrial premature depolarization	No CC/MCC	-0.901	1389	n j code lines (-0.50), work rvu (-0.48), organ system count (+0.25)
I6523	Occlusion and stenosis of bilateral carotid arteries	No CC/MCC	-0.912	947	work rvu (-0.44), n j code lines (-0.41), n distinct rev codes (+0.40)
E7800	Pure hypercholesterolemia, unspecified	No CC/MCC	-0.918	3891	or (-0.30), n j code lines (-0.23), relative claim charge (-0.20)
E1140	Type 2 diabetes mellitus with diabetic neuropathy, unspecified	No CC/MCC	-0.999	533	work rvu (-0.44), or (-0.43), organ system count (-0.23)

Tier 2 (n=29 codes)

code	Description	CMS severity	Score	N claims	Key drivers
I4710	Supraventricular tachycardia, unspecified	No CC/MCC	0.932	4144	organ system count (+0.33), work rvu (+0.25), n j code lines (+0.24)
I493	Ventricular premature depolarization	No CC/MCC	0.781	4598	organ system count (+0.30), relative claim charge (+0.25), n j code lines (+0.11)
I340	Nonrheumatic mitral (valve) insufficiency	No CC/MCC	0.670	1671	n distinct rev codes (+0.25), organ system count (+0.15), or (+0.14)
F17200	Nicotine dependence, unspecified, uncomplicated	No CC/MCC	0.587	564	n distinct rev codes (+0.35), n j code lines (+0.17), relative claim charge (+0.09)
I4719	Other supraventricular tachycardia	No CC/MCC	0.537	2027	n j code lines (+0.30), n distinct rev codes (-0.28), relative claim charge (+0.28)
I2720	Pulmonary hypertension, unspecified	No CC/MCC	0.396	767	n distinct rev codes (+0.26), or (+0.23), n j code lines (+0.16)
I252	Old myocardial infarction	No CC/MCC	0.158	2690	n distinct rev codes (+0.17), or (-0.14), relative claim charge (-0.12)
I119	Hypertensive heart disease without heart failure	No CC/MCC	0.124	1168	n distinct rev codes (+0.51), n j code lines (-0.20), work rvu (-0.14)
F32A	Depression, unspecified	No CC/MCC	0.111	1641	or (+0.58), organ system count (-0.42), n distinct rev codes (+0.37)
F419	Anxiety disorder, unspecified	No CC/MCC	0.083	2318	or (+0.42), organ system count (-0.34), n j code lines (+0.28)

Tier 3 (n=11 codes)

code	Description	CMS severity	Score	N claims	Key drivers
I255	Ischemic cardiomyopathy	No CC/MCC	3.241	663	work rvu (+1.11), relative claim charge (+0.83), n j code lines (+0.60)
I441	Atrioventricular block, second degree	No CC/MCC	3.091	817	relative claim charge (+1.13), work rvu (+0.67), or (+0.67)
I440	Atrioventricular block, first degree	No CC/MCC	2.939	947	n distinct rev codes (+0.86), relative claim charge (+0.85), or (+0.42)
I4510	Unspecified right bundle-branch block	No CC/MCC	2.669	1167	relative claim charge (+1.17), work rvu (+0.68), or (+0.23)
I495	Sick sinus syndrome	No CC/MCC	2.157	1749	n j code lines (+0.81), work rvu (+0.77), organ system count (+0.31)
I483	Typical atrial flutter	CC	1.819	1096	work rvu (+0.76), or (+0.66), n distinct rev codes (-0.53)
I498	Other specified cardiac arrhythmias	No CC/MCC	1.705	520	n j code lines (+0.52), or (+0.45), organ system count (+0.38)
I447	Left bundle-branch block, unspecified	No CC/MCC	1.546	1160	work rvu (+0.73), relative claim charge (+0.50), organ system count (+0.24)
I5022	Chronic systolic (congestive) heart failure	CC	1.493	902	work rvu (+0.72), relative claim charge (+0.28), n distinct rev codes (+0.21)
I429	Cardiomyopathy, unspecified	CC	1.437	824	work rvu (+0.71), n j code lines (+0.41), or (+0.25)

Tier 4 (n=4 codes)

code	Description	CMS severity	Score	N claims	Key drivers
I4729	Other ventricular tachycardia	No CC/MCC	8.219	1734	n j code lines (+2.15), work rvu (+1.96), n distinct rev codes (+1.30)
I452	Bifascicular block	CC	4.995	621	relative claim charge (+1.39), work rvu (+1.17), n distinct rev codes (+0.96)
I428	Other cardiomyopathies	CC	4.276	938	work rvu (+1.33), n j code lines (+1.09), or (+0.99)
I4720	Ventricular tachycardia, unspecified	No CC/MCC	4.135	2451	work rvu (+1.36), relative claim charge (+0.95), n j code lines (+0.91)

Key Driver Frequency

feature	count	pct
work rvu	43	56.600
n j code lines	43	56.600
n distinct rev codes	37	48.700
or	36	47.400
organ system count	33	43.400
relative claim charge	31	40.800
icu	2	2.600
n imaging lines	2	2.600
transfusion	1	1.300