Episode List
Below is the list of episode definitions used in our under-65 commercially insured, Medicaid and Medicare Advantage programs.
Category |
Name |
Acronym |
Version 1 |
|---|---|---|---|
| Cardiac | Arrhythmia / Heart Block / Conduction Disorders (ARRBLK) Episode Description | ARRBLK | Definition |
| Respiratory System | Asthma (ASTHMA) Episode Description | ASTHMA | Definition |
| Gastrointestinal | Bariatric Surgery (BARI) Episode Description | BARI | Definition |
| Behavioral Health | Bipolar Disorder (BIPLR) Episode Description | BIPLR | Definition |
| Skin, Tissue & Breast | Breast Biopsy (BSTBIO) Episode Description | BSTBIO | Definition |
| Eye | Cataract Surgery (CTRTSU) Episode Description | CTRTSU | Definition |
| Maternity | Cesarean Section (CSECT) Episode Description | CSECT | Definition |
| Respiratory System | Chronic Obstructive Pulmonary Disease (COPD) Episode Description | COPD | Definition |
| Gastrointestinal | Colon Resection (COLON) Episode Description | COLON | Definition |
| Gastrointestinal | Colonoscopy (COLOS) Episode Description | COLOS | Definition |
| Cardiac | Coronary Artery Bypass Grafting with or without Valve Procedures (CXCABG) Episode Description | CXCABG | Definition |
| Cardiac | Coronary Artery Disease (CAD) Episode Description | CAD | Definition |
| Gastrointestinal | Crohn’s Disease (CROHNS) Episode Description | CROHNS | Definition |
| Behavioral Health | Depression and Anxiety (DEPANX) Episode Description | DEPANX | Definition |
| Endocrine | Diabetes (DIAB) Episode Description | DIAB | Definition |
| Gastrointestinal | Esophagogastroduodenoscopy Upper GI- Endoscopy (EGD) Episode Description | EGD | Definition |
| Gastrointestinal | Gall Bladder Surgery (GBSURG) Episode Description | GBSURG | Definition |
| Gastrointestinal | Gastro-Esophageal Reflux Disease (GERD) Episode Description | GERD | Definition |
| Cardiac | Heart Failure (HF) Episode Description | HF | Definition |
| Musculoskeletal | Hip Replacement (HIPRPL) Episode Description | HIPRPL | Definition |
| Cardiac | Hypertension (HTN) Episode Description | HTN | Definition |
| Female Reproductive System | Hysterectomy (HYST) Episode Description | HYST | Definition |
| Musculoskeletal | Knee Arthroscopy (KNARTH) Episode Description | KNARTH | Definition |
| Musculoskeletal | Knee Replacement & Knee Revision Episode Description | KNRPL | Definition |
| Musculoskeletal | Low Back Pain (LBP) Episode Description | LBP | Definition |
| Musculoskeletal | Lumbar Laminectomy (LBRLAM) Episode Description | LBRLAM | Definition |
| Musculoskeletal | Lumbar Spine Fusion (FUSION) Episode Description | FUSION | Definition |
| Respiratory System | Lung Resection (LNGSRG) Episode Description | LNGSRG | Definition |
| Skin, Tissue & Breast | Mastectomy (MSTCMY) Episode Description | MSTCMY | Definition |
| Maternity | Newborn (NBORN) Episode Description | NBORN | Definition |
| Musculoskeletal | Osteoarthritis (OSTEOA) Episode Description | OSTEOA | Definition |
| Cardiac | Pacemaker/Defibrillator (PCMDFR) Episode Description | PCMDFR | Definition |
| Cardiac | Percutaneous Coronary Intervention- (Angioplasty) (PCI) Episode Description | PCI | Definition |
| Maternity | Pregnancy (PREGN) Episode Description | PREGN | Definition |
| Male Reproductive System | Prostatectomy (PRSCMY) Episode Description | PRSCMY | Definition |
| Behavioral Health | Schizophrenia (SCHIZO) Episode Description | SCHIZO | Definition |
| Musculoskeletal | Shoulder Replacement (SHLDRP) Episode Description | SHLDRP | Definition |
| Behavioral Health | Substance Use Disorder (SUDS) Episode Description | SUDS | Definition |
| Nose & Throat | Tonsillectomy (TONSIL) Episode Description | TONSIL | Definition |
| Male Reproductive System | Transurethral Resection Prostate (TURP) Episode Description | TURP | Definition |
| Behavioral Health | Trauma and Stressors Disorders (PTSD) Episode Description | PTSD | Definition |
| Gastrointestinal | Ulcerative Colitis (ULCLTS) Episode Description | ULCLTS | Definition |
| Maternity | Vaginal Delivery (VAGDEL) Episode Description | VAGDEL | Definition |
