Elixhauser Comorbidity Software for ICD-10-CM The Elixhauser Comorbidity Software is one in a family of databases and software tools developed as part of the Healthcare Cost and Utilization Project (HCUP), a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality. HCUP databases, tools, and software inform decision making at the national, State, and community levels.
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The Elixhauser Comorbidity Software for ICD-10-CM assigns variables that identify comorbidities in hospital discharge records using the diagnosis coding of ICD-10-CM. This Web page describes the software that created the original ICD-9-CM comorbidity measures reported by Elixhauser et al. 1
The Elixhauser Comorbidity Software for ICD-10-CM consists of two SAS computer programs for personal computers. Although these programs are written in SAS, they are being distributed in ASCII so that they can be readily adapted to other programming languages. The first program, Creation of Format Library for Elixhauser Comorbidity Groups, creates a SAS format library that maps diagnosis codes into comorbidity indicators. Additional formats are created to exclude conditions that may be complications or that may be related to the principal diagnosis
1 Elixhauser A, Steiner D, Harris DR, et al. Comorbidity measures for use with administrative data. Med Care, 1998;36(1):8-27. |
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Two SAS programs comprise the Elixhauser Comorbidity Software for ICD-10-CM. They are described below.
Format Program The format program defines a format library that contains the diagnosis and ICD-10 MS-DRG screens necessary for the comorbidity analysis. The format library is referenced by the comorbidity analysis program.
The input data file must contain certain elements that are coded in specific ways. These elements are required for the assignment of the comorbidity flags. The flags are 0/1 indicators that note whether individual records include each comorbidity. Analysis Program The analysis program assigns 0/1 indicators to the inpatient records for the comorbidity variables of interest. This program assumes that the input data file conforms to specific variables names, attributes, and coding conventions, as described above. This version of Elixhauser Comorbidity Software works with ICD-10 MS-DRG.
The macro variable (CORE) that defines the input file (SASname) needs to be defined; change the XXXXXX to the appropriate name. An options statement defines page and line size preferences; the settings currently are linesize=159 and pagesize=56. These settings can be changed, depending on whether you prefer a portrait or landscape style output. Diagnoses and DRGs ICD-10-CM and ICD-10 MS-DRG (V33) coding changes through September 30, 2017, are incorporated into this software.
Variables Created The library contains formats for the ICD-10-CM codes and DRG and MS-DRG screens. Construction of these variables is summarized in Table 2 - Definition of Comorbidities for ICD-10-CM (PDF file, 168 KB). The analysis program creates these 29 comorbidity measures: CHF, VALVE, PULMCIRC, PERIVASC, HTN_C (using HTN, HTNCX), PARA, NEURO, CHRNLUNG, DM, DMCX, HYPOTHY, RENLFAIL, LIVER, ULCER, AIDS, LYMPH, METS, TUMOR, ARTH, COAG, OBESE, WGHTLOSS, LYTES, BLDLOSS, ANEMDEF, ALCOHOL, DRUG, PSYCH, DEPRESS. |
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System Requirements
In order to use the Elixhauser Comorbidity Software for ICD-10-CM, you will need SAS software and approximately 2 megabytes of disk space available on your hard drive to accommodate the SAS program files. Required Data Elements The input data set must have the following two variables:
The required elements and coding are described in more detail below. Required Elements of Input File |
Element | Type | Length | Label and Uniform Coding |
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DRG | Num | 3 | ICD-10 MS-DRG in effect on discharge date |
DX1 | Char | 7 | Principal diagnosis, ANAAAAA (blanks indicate missing, A indicate alphanumeric and N numeric) |
DX2-DXn | Char | 7 | Secondary diagnoses 2-n, where n varies by data set |
NDX | Num | 3 | Number of diagnoses on this discharge. (Note: A macro variable defines this element; it is currently set as 2.) NDX should always be equal or less than the macro variable called NUMDX. |
Using the Software
The Elixhauser Comorbidity Software for ICD-10-CM requires SAS but the ASCII file can be adapted to other types of software such as STATA or SPSS. The format program creates a SAS format library that maps diagnosis codes into comorbidity indicators. The analysis program applies the formats created above to a data set containing administrative data and then creates the comorbidity variables. Representation of ICD-10-CM Diagnosis Codes In practice, ICD-10-CM diagnoses are represented by 3- to 7-character codes with explicit decimals. In the files that you downloaded and in the vast majority of data files, ICD-10-CM diagnoses are represented with implicit decimals (no decimals present). (Alphanumeric codes are always enclosed in quotation marks.) Examples are given below. |
Condition | ICD-10-CM diagnosis code | Alphanumeric code (with implicit decimals) |
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Reactive arthropathy, unspecified | M02.9 | 'M029 ' |
Other reactive arthropathies, multiple sites | M02.89 | 'M0289 ' |
Other reactive arthropathies, unspecified ankle and foot | M02.879 | 'M02879 ' |
For proper handling of diagnosis codes:
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Shift-click from this Web page: Your browser may support loading the files for the ICD-10-CM Elixhauser Comorbidity Software from this Web page. To download the files from this Web page, click on the following links with the right mouse button and select Save Link As (Netscape®) or Save Target As (Internet Explorer®). After saving a file, find the file by using Windows® Explorer (Windows 98/95/NT/Vista/7/8/10) or File Manager (Windows 3.x) and then open it by double clicking on it.
October 2016 - Version 1.1 (valid for ICD-10-CM codes and v34 ICD-10 MS-DRGs)
Although they are written in SAS, all files are being distributed in ASCII so they can be readily adapted to other programming languages. |
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Copies of previous versions of the Elixhauser Comorbidity Software for ICD-10-CM are available for users who need to replace or access the old SAS programs.
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There are currently no publications using the Elixhauser Comorbidity Software for ICD-10-CM. Click here to see a partial list of publications using the Elixhauser Comorbidity Software for ICD-9-CM.
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Questions regarding the Elixhauser Comorbidity Software for ICD-10-CM may be directed to HCUP User Support through the following channels:
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Internet Citation: Elixhauser Comorbidity Software for ICD-10-CM, Version 1.1. Healthcare Cost and Utilization Project (HCUP). October 2016. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp. |
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Last modified 10/13/16 |