Use of Risk Adjustment Models for Provider Reimbursements - Text Mining Techniques for Healthcare Provider Quality Determination - page 373

Table 10. Most frequent codes for patients with 5 or more clusters compared to patients with fewer than
5 clusters

Fewer Than
5 Codes

Translation of Codes Frequency 5 Or More

Codes

Translation of Codes Frequency

V3000 Single liveborn without C-sec-

tion

5388 4019 Unspecified hypertension 10153

V270 Singe liveborn 5360 4280 Congestive Heart Failure 4721

4019 Unspecified hypertension 4478 25000 Diabetes Mellitus 3846

4280 Congestive Heart Failure 2719 41401 Coronary atherosclerosis 3652

V3001 Single liveborn With C-section 2211 42731 Atrial fibrillation 3599

42731 Atrial fibrillation 2011 496 Chronic airway obstruction, not else-

where classified

2828

V053 Viral hepatitis 1960 5990 Urinary tract infection, site not speci-

fied

2633

486 Pneumonia, organism unspeci-

fied

1637 2724 Other and unspecified hyperlipidemia 2573

2765 Disorders of fluid, electrolyte,

and acid-base balance, Volume
depletion

1627 486 Pneumonia, organism unspecified 2278

3051 Tobacco use disorder 1562 2765 Disorders of fluid, electrolyte, and acid-

base balance, Volume depletion

2245

5990 Urinary tract infection, site not

specified

1548 53081 Esophageal reflux 2171

25000 Diabetes mellitus 1510 3051 Tobacco use disorder 2129

41401 Coronary atherosclerosis 1504 2449 Unspecified hypothyroidism 1720

496 Chronic airway obstruction, not

elsewhere classified

1492 V270 Singe liveborn 1671

7746 Unspecified fetal and neonatal

jaundice

1259 2859 Anemia, unspecified 1499

53081 Esophageal reflux 1044 2720 Pure hypercholesterolemia 1395

2724 Other and unspecified hyperlipi-

demia

974 40391 Hypertensive chronic kidney disease 1373

40391 Hypertensive chronic kidney

disease

910 78039 Convulsions 1343

5849 Acute renal failure, unspecified 855 2761 Hyposmolality and/or hyponatremia 1263

Table 12 has the clusters from 4 or fewer codes; and also the clusters for 5 or more codes. These
clusters were defined using text analysis.
We need to consider how the clusters differ, compared by the number of classes. Consider cluster 11
in both groups. For fewer than five codes:

• Other cellulitis and abscess (Upper arm and forearm)

• Other cellulitis and abscess (Trunk)

• Staphylococcus aureus

• Other cellulitis and abscess (Foot, except toes)