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Outcome Hierarchy

outcome_hierarchy.Rmd

Outcome Hierarchy

If multiple conflicting outcomes occur on the same day, the outcomes for that service day will be reassigned based on the logic below. However, the trimester codes will be preserved and unaffected.

Acceptable Combinations:

  • Delivery/Live Birth/C-Section/Twin

  • Delivery/Live Birth/C-Section/Multiple

  • Delivery/Live Birth/C-Section/Term/Postpartum

  • Delivery/Live Birth/C-Section/Term/Postpartum/Twin

  • Delivery/Live Birth/C-Section/Term/Postpartum/Multiple

  • Delivery/Live Birth/C-Section/Post Term/Postpartum

  • Delivery/Live Birth/C-Section/Post Term/Postpartum/Twin

  • Delivery/Live Birth/C-Section/Post Term/Postpartum/Multiple

  • Delivery/Live Birth/C-Section/Pre-Term

  • Delivery/Live Birth/C-Section/Pre-Term/Twin

  • Delivery/Live Birth/C-Section/Pre-Term/Twin/Postpartum

  • Delivery/Live Birth/C-Section/Pre-Term/Multiple

  • Delivery/Live Birth/C-Section/Pre-Term/Multiple/Postpartum

  • Delivery/C-Section/Stillborn/Unclassified Pregnancy Loss & Twin

  • Delivery/C-Section/Stillborn/Unclassified Pregnancy Loss & Multiple

  • Delivery/C-Section/Stillborn/Unclassified Pregnancy Loss

  • Spontaneous Abortion/Unclassified Pregnancy Loss/Postpartum

  • Induced Abortion/Unclassified Pregnancy Loss/Postpartum

  • Stillborn/Unclassified Pregnancy Loss/Postpartum

  • Ectopic Pregnancy/Unclassified Pregnancy Loss/Postpartum

  • Pregnancy with any acceptable Outcome combination

  1. If outcome of “Twin Birth” and “Twin Birth*”, overwrite “Twin Birth*”, as “Twin Birth” for entire pregnancy

    If outcome of “Multiple Birth Unspecified” and “Multiple Birth Unspecified *”, overwrite “Multiple Birth Unspecified *”, as “Multiple Birth Unspecified” for entire pregnancy

    If outcome of “Multiple Birth” and “Multiple Birth*”, overwrite “Multiple Birth*”, as “Multiple Birth” for entire pregnancy

    If outcome of “Twin Birth*” and “Multiple Birth Unspecified*”, overwrite “Multiple Birth Unspecified*” as “Twin Birth*” for entire pregnancy

    Any non-stars use non-star; when both stars, use stars

    If outcome of “Twin Birth*” and “Multiple Birth Unspecified*”, overwrite “Multiple Birth Unspecified*” as “Twin Birth*” for entire pregnancy

    If outcome of “Multiple Birth” and “Multiple Birth Unspecified”, overwrite “Multiple Birth Unspecified” as “Multiple Birth” for entire pregnancy

    If outcome of “Twin Birth” and “Multiple Birth”, then classify as “Multiple Birth Unspecified” for entire pregnancy

    Entire pregnancy defined as 270 days

  2. Regardless of L&D Codes; if multiple losses occur within 60 days, apply hierarchy

    1. Ectopic pregnancy
    2. Spontaneous abortion
    3. Induced abortion
    4. Stillbirth
    5. Unclassified pregnancy loss

  3. No multiples (within 180 days):

    Loss outcome within -30 days to +60 days of a Labor & Delivery Code

    Labor & Delivery outcome will be overwritten

    Spontaneous abortion & Labor & Delivery Codes = Spontaneous abortion

    Ectopic & Labor & Delivery Codes = Ectopic

    Induced abortion & Labor & Delivery Codes = Induced abortion

    Stillbirth abortion & Labor & Delivery Codes = Stillbirth

    # Unclassified outcomes >= # Labor & Delivery Codes = Unclassified

    # Unclassified < # Labor & Delivery Codes = Pregnancy*

  4. No multiple pregnancy within 180 days:

    Labor & Delivery Codes within +60 days to +180 days of a Loss outcome

    Loss outcome will be overwritten

    Ectopic & more than 1 Labor & Delivery Codes = Pregnancy*

    Spontaneous abortion & more than 1 Labor & Delivery Codes = Pregnancy*

    Induced abortion & more than 1 Labor & Delivery Codes = Pregnancy*

    Stillbirth abortion & more than 1 Labor & Delivery Codes = Pregnancy*

    Unclassified & more than 1 Labor & Delivery Codes = Pregnancy*

  5. If multiple Term outcomes occur within -60 days to +60 days of each other, apply the following hierarchy:

    1. Pre-term
    2. Term
    3. Post-term
    4. Post-term*

“CAPS” refers to outcome classification grouping

Classification of outcomes

Outcome Use codes for
Cesarean section Cesarean section
Delivery Delivery ⚠ If a more specific outcome code for Delivery is available, use it instead. More specific outcomes are: Cesarean Section, Childbirth, Multiple Birth, Unspecified Multiple Birth, Post-term Birth, Preterm Birth, Term Birth, Twin Birth
Ectopic pregnancy Ectopic pregnancy
Induced abortion Induced abortion
Live birth Live birth
Multiple birth (more than twins) Multiple birth (more than twins)
Multiple births (twins and above) Twin birth, Multiple birth unspecified (meaning twins and above), Multiple birth unspecified*
Post-term birth Post-term birth
Postpartum Postpartum
Pregnancy Any code
Preterm birth Preterm birth
Spontaneous abortion Spontaneous abortion
Still birth Still birth
Term birth Term birth
Twin birth Twin birth
Twin birth* Twin birth*
Unclassified pregnancy loss Unclassified pregnancy loss
Total Pregnancy loss Ectopic pregnancy, Induced abortion, Spontaneous abortion, Still birth, Unclassified pregnancy loss (only 1 per woman)