OP - RA.0.qMRI

CM Codes

Data Overview

1996 total codes in komodo_rii; 3 retained after n_claims > 500 filter.

CMS severity	n codes
No CC/MCC	3

PCA Analysis

PC1 explains 70.5% of variance; PC1+PC2 together explain 100.0%.

Tier Clustering (k=3)

Tier Summary

tier	n_codes	n_claims	n distinct rev codes	work rvu	n j code lines	n imaging lines	organ system count	n distinct hcps	relative claim charge	transfusion
1	1.000	725.000	3.700	3.215	0.619	2.958	1.392	0.836	0.983	0.002
2	1.000	1990.000	2.388	1.869	0.035	2.410	1.239	0.941	0.961	0.000
3	1.000	872.000	2.070	2.542	0.034	2.377	1.094	0.759	1.062	0.000

CMS Severity × intensity Tier

cms_severity	Tier 1	Tier 2	Tier 3	All
No CC/MCC	1	1	1	3
All	1	1	1	3

Feature Analysis

Feature Correlation

Feature Audit

	pc1_loading	r_with_volume	r_with_severity
avg_relative_claim_charge	0.183	-0.500	nan
avg_length_of_stay	0.000	nan	nan
rate_dialysis	0.000	nan	nan
rate_icu	-0.000	nan	nan
rate_mechanical_ventilation	0.000	nan	nan
rate_multiple_or_days	0.000	nan	nan
rate_or	0.000	nan	nan
avg_n_distinct_hcps	-0.019	0.500	nan
avg_work_rvu	-0.333	-1.000	nan
avg_organ_system_count	-0.392	-0.500	nan
avg_n_j_code_lines	-0.417	-0.500	nan
rate_transfusion	-0.417	-0.866	nan
avg_n_imaging_lines	-0.420	-0.500	nan
avg_n_distinct_rev_codes	-0.421	-0.500	nan

Top 6 Tier-Discriminating Features

Bottom 6 Tier-Discriminating Features

Score Validation

Misclassification Audit (N=10 samples)

Over-tiered: Tier 3, No CC/MCC (1 codes)

code	code_description	cms_severity	intensity_score	tier	n_claims	key_drivers
G35	None	No CC/MCC	2.050	3	872	organ system count (+0.48), n distinct rev codes (+0.39), n imaging lines (+0.32)

Under-tiered: Tier 1, MCC (0 codes)

None.

Top Codes by Tier

Tier 1 (n=1 codes)

code	Description	CMS severity	Score	N claims	Key drivers
I517	Cardiomegaly	No CC/MCC	-3.328	725	n imaging lines (-0.59), n j code lines (-0.59), transfusion (-0.59)

Tier 2 (n=1 codes)

code	Description	CMS severity	Score	N claims	Key drivers
G3184	Mild cognitive impairment of uncertain or unknown etiology	No CC/MCC	1.278	1990	work rvu (+0.41), transfusion (+0.30), n j code lines (+0.29)

Tier 3 (n=1 codes)

code	Description	CMS severity	Score	N claims	Key drivers
G35	None	No CC/MCC	2.050	872	organ system count (+0.48), n distinct rev codes (+0.39), n imaging lines (+0.32)

Key Driver Frequency

feature	count	pct
n imaging lines	2	66.700
n j code lines	2	66.700
transfusion	2	66.700
work rvu	1	33.300
organ system count	1	33.300
n distinct rev codes	1	33.300