All numbers and rates pertain to place of residence (not occurrence).

Ambulatory Care Sensitive Conditions (ACSC)
Conditions that respond to timely and effective care in the outpatient (ambulatory) setting. ACSC's are used as Prevention Quality Indicators, and can assist in evaluating quality or use of primary health care.
Formula = [The number of ACSC's discharges (or ER visits) / The total number of discharges (or ER visits)] * 100
While primarily intended for application to hospital inpatient data, we have applied to ER Visit data as well.

AMBULATORY CARE SENSITIVE CONDITIONS
PREVENTABLE CONDITION ICD10 codes followed by ICD-9-CM
codes in brackets. (By Primary Diagnosis Unless Otherwise Noted,
Secondary diagnoses are all other available diagnosis)
COMMENTS
AVOIDABLE ILLNESSES
Congenital Syphilis A50 [090] Secondary diagnosis for newborns only
Failure to thrive R62.51, R62.52, R62.0, R62.50 [783.41] Age < 1 Year
Dental Conditions K02, K03, K04, K05, K06.0, K06.1, K06.2, K08, K12, K13, M27.6, A69.0, K09.8 [521-523,525,528]  
Vaccine Preventable Conditions/Immunization-related and preventable conditions A33, A34, A35, A37, A80, G00.0, I01 [032,033,037,041.5,045,052.1,052.9,055-056,070.0-070.3,072, 320.2*, 320.3,390,391,771.0] *Hemophilus meningitis G00.2 [320.2] for ages 1-5 only
Iron Deficiency Anemia D50.1, D50.8, D50.9 [280.1,280.8,280.9] Age 0-5 only. Primary & Secondary Diagnoses
Nutritional Deficiencies E40, E41, E43, E55.0, E64.3 [260-262,268.0,268.1] Primary & Secondary Diagnoses
ACUTE CONDITIONS
Bacterial Pneumonia J13, J14, J153, J154, J157, J159, J16, J18 [481,482.2,482.3,482.9,483,485,486] Exclude case with secondary diagnosis of sickle cell D57 and patients < 2 months
Cancer of the Cervix [180.0-180.1, 180.8-180.9] No Longer an ACSC in ICD10
Cellulitis L03, L04, L08, L88, L98.0 [681,682,683,686] Excludes cases with a surgical procedure starting with 0 or 1, [01-86.99], except incision of skin and subcutaneous tissue 0H, 0J, 0W, OX, [86.0] where it is the only listed surgical procedure
Convulsions R56 [780.3]  
Dehydration  - Volume Depletion  E86 [276.5] Primary & Secondary Diagnoses examined separately
Gastroenteritis K52.9, K52.89 [558.9]  
Hypoglycemia E16.2 [251.2]  
Kidney/Urinary Infection N10, N11, N12 [590.0,599.0,599.9]  
Pelvic Inflammatory Disease N70, N73 [614] Exclude cases with a surgical procedure of hysterectomy 0UT
Severe Ear, Nose, & Throat Infections H66, J02, J03, J06, J31.2 [382*,462,463,465,472.1] *Excludes otitis media H66, H67 [382] cases with myringotomy with insertion of tube C83.5 [20.01]1
Skin Grafts with Cellulitis {DRGs: 263 & 264} For 2008: {DRGs: 573, 574, 575} Excludes admissions from SNF/ICF
CHRONIC CONDITIONS
Angina I20, I24.0, I24.8, I24.9 [411.1,411.8,413] Excludes cases with a surgical procedure 0 or 1 [01-86.99]1
Asthma J45 [493]
Chronic Obstructive Pulmonary Disease J20, J40, J41, J42, J43, J44, J47 [466.0*,491,492,494,496] *Includes acute bronchitis J20.9 [466.0] only with secondary diagnosis of J41, J42, J43, J44, J47 [491,492,494,496]
Congestive Heart Failure I50, I11.0, J81.0 [402.01,402.11,402.91,428,518.4] Excludes cases with the following surgical procedures: 02 [36.01,36.02,36.05,36.1,37.5 or 37.7]1
Diabetes with ketoacidosis or hyperosmolar coma or other coma E10.1, E13.1, E11.0, E13.0, E10.641, E11.641 [250.1-250.33]  
Diabetes with other specified or unspecified complications E10.6, E11.6, E10.8, E11.8 [250.8-250.93]  
Diabetes mellitus without mention of complications or unspecified hypoglycemia E10.9, E11.9 [250-250.04]  
Grand Mal & Other Epileptic Conditions G40 [345]  
Hypertension I10, I11.9 [401.0,401.9,402.00,402.10,402.90] Excludes cases with the following procedures: 02 [36.01,36.02,36.05,36.1,37.5 or 37.7]
Tuberculosis (Non-Pulmonary) A15.4, A15.6, A15.8, A17, A18, A19 [012-018]  
Pulmonary Tuberculosis A15.0, A15.5, A15.9 [011]  

1 – Procedure codes: For ICD9, not all records used ICD9 procedure codes.

Please note: Some records may have more than one ACSC, in which case the first discovered is reported.

Cause of Discharge/ER Visit
Causes are based on the principal diagnosis, except where the principal diagnosis is an injury code. All discharges/ER visits having ICD-9-CM external causes (injuries) are assigned their appropriate External Cause of Injury Code (E-Code) in accordance with STIPDA (State and Territorial Injury Prevention Directors Association) 2003 guidelines. The standards can be found at: http://www.safestates.org/.
Similarly, all hospital discharges/ER visits having ICD-10-CM causes are based on the principal diagnosis, except where the principal diagnosis is an Injury code. If so, the Discharge/ER visit is assigned the appropriate External Cause of Injury in accordance with Safe States guidelines.
Discharges/ER Visits
The number of discharges/ER Visits from non-Federal acute-care inpatient facilities. Only discharges/visits of Georgia residents who were seen in a Georgia facility are included. Persons can be counted more than once if readmitted. Discharges/visits include people both living and who have died.
International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM)
A statistical classification system, in use since 1979, that arranges diseases and injuries into groups according to established criteria. It is used to improve comparability of cause of death statistics reported by different governmental entities. Most ICD-9-CM codes are numeric and consist of three, four or five numbers and a description. The codes are revised approximately every 10 years by the World Health Organization and annual updates are published by the Health Care Financing Administration (HCFA), now the Center for Medicare, Medicaid Services.
International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) vs. ICD10
The National Center for Health Statistics (NCHS), the Federal agency responsible for use of the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) in the United States, has developed a clinical modification (CM) of the classification for morbidity (hospital and ER data) purposes. The ICD-10 is used to code and classify mortality data from death certificates, having replaced ICD-9 for this purpose as of January 1, 1999. ICD-10-CM is the replacement for ICD-9-CM, effective October 1, 2015 in discharge and ER data.
The ICD-10 is copyrighted by the World Health Organization (WHO). WHO has authorized the development of an adaptation of ICD-10 for use in the United States (ICD-10-CM). All modifications to the ICD-10 must conform to WHO conventions for the ICD. https://www.cdc.gov/nchs/icd/icd10cm.htm
Lifestages
An age year grouping methodology based upon predictable mortality. Georgia uses the following Lifestages: <1 Infancy, 1-4 Early Childhood, 5-12 Later Childhood, 13-19 Adolescence, 20-29 Early Adulthood, 30-44 Young Adulthood, 45-59 Middle Adulthood, 60-74 Late Adulthood, and 75+ Older Adulthood. The highest value for age is 120 years.
Non-Rural
Any county with 35,000 or more total population per year 2000 Census.
Payor
Payor is the primary entity responsible for payment of services. Values for Payor include:
Percent ACSC Discharges/ER Visits
Formula = [The number of ACSC's discharges (or ER visits) / The total number of discharges (or ER visits)] * 100
Race
Per the Federal Office of Management and Budget, Directive 15 (1997),

Note: Rates for years prior to year 2000 use population estimates for the denominator that adhere to a different Federal standard for race: White, Black, Asian or Other Pacific Islander, American Indian and Alaska Native. So, unlike years 2000 and after, Multiracial is not included. Also, Asian by itself is not available because it was grouped with Pacific Islander (After 1999 Asian is separate from Native Hawaiian or Other Pacific Islander).

Rates using Census Population Estimates in the denominator are not calculated when a selected race is not available in the denominator, or zero.

Nevertheless, selections available in OASIS' Race query box reflect the 1997 Race classifications described above. Most of the numerators used in indicators in Oasis *do* have the year 2000 race selections. Therefore, selections of multiple years that span <2000 and 2000+ will return a *number (count)* for all race selections, but the *rates* may be limited by the change in racial classifications the federal government used as noted above. In these cases you will see NA1 in the output cell (NA1 therefore by definition will only show up in rates for the years before 2000).

In some cases, the numerator's race classification may be more precise, or up to date, than the Census population estimate counterpart used in the denominator. You may find that there are a number of births of a given race for a county/age-group selection, but no count of population estimated for the denominator. In such cases where the race selection was available for both the numerator and the denominator, but the denominator's estimate was zero, you will see a NA2. If the numerator was greater than the denominator, but the denominator was > 0, you will see a NA3 returned.

Rural
Any county with less than 35,000 total population per year 2000 Census.

V1.1 (11/2/2017)