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Patient Safety Indicator 17 (PSI 17) Software Version SAS v2024
RELEASE DATE: July 2024
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This version of AHRQ's all-payer software is named SAS QI v2024
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- Reflects coding changes based on fiscal year 2024 coding updates to the International Classification 
  of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS). These coding 
  changes impact all software modules.
- Includes modified code sets, labels, and output in multiple modules. See log of changes for 
  indicator-by-indicator changes.
- The software no longer provides options to include or exclude COVID discharges. 
- Revised Major Diagnostic Category (MDC) Requirements
     • SAS QI v2024 now includes additional checks on user input for MDC_PROVIDED to avoid software errors. 
       In the case where MDC_PROVIDED is not 0 or 1, or if MDC_PROVIDED = 1 but the MDC values are out of range of 
       0-25, the software will not execute to avoid errors or unexpected results. 
     • Different versions of the Medicare Severity-Diagnostic Related Group (MS-DRG) grouper produce
       slightly different results with respect to certain high resource intensity MS-DRGs. Specifically, MSDRGs
       001-019 and 981-989 are classified as "pre-MDC" MS-DRGs, which means that they are
       associated with such high length of stay and/or cost that they supersede the usual assignment of MSDRGs
       within body system or MDC categories. For records assigned to these MS-DRGs, some versions of
       the grouper software retain the MDC that would be assigned based on the principal diagnosis and
       procedure codes, whereas other versions of the grouper software overwrite the MDC assignment with a
       blank, missing, or nonnumeric value such as "PRE." Thus, users MUST PROVIDE the MDC generated
       by the Centers for Medicare & Medicaid Services (CMS) MS-DRG grouper software, without imputing
       or mapping from MS-DRGs. For accurate results, all eligible records should have an MDC between 01
       and 25. For those users who need to construct MDC, please view the documentation and software
       available here: https://www.cms.gov/files/zip/icd-10-ms-drg-definitions-manual-files-v411.zip.
     • CMS' MS-DRG grouper software is updated on October 1 of each year, to accommodate new ICD-10-CM/PCS 
       codes introduced on that date, and it is further updated on any other date when new codes take
       effect. As a result, the grouper software version that worked on discharge records dated between January
       1 and September 30 of any calendar year does NOT work correctly on discharge records dated between
       October 1 and December 31 of the same calendar year. MS-DRG grouper software is designed for
       backward compatibility, based on the discharge date of each record. Therefore, a user who wishes to
       analyze CY 2023 data must use the version 41 (FY 2024) grouper (or later), while a user who wishes to
       analyze CY 2022 data must use the version 40 (FY 2023) grouper (or later). Many errors will result if a
       user applies the version 40 (FY 2023) grouper to data from the last quarter of CY 2023.

Measure specific changes are outlined on the AHRQ QI website;
PSI - https://www.qualityindicators.ahrq.gov/Downloads/Modules/PSI/v2024/ChangeLog_PSI_v2024.pdf

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Patient Safety Indicator 17 (PSI 17) Software Version SAS v2023
Release date: AUGUST 2023
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This version of AHRQ's all-payers version is named SAS QI v2023
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- Reflects coding changes based on fiscal year 2023 coding updates to the International Classification 
  of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS). 
  These coding changes impact all software modules.
- Includes modified code sets, labels, and output in multiple modules. See log of changes for indicator changes.
- Revised Major Diagnostic Category (MDC) Requirements
     • Users must have major diagnostic categories (MDC) assigned for each discharge on their input file. 
	   MDCs are used in measure specifications. Since v2022, the AHRQ software does not impute MDC because the
       calculation was error-prone when the correct classification software was not applied to the input data.
       However, running the MS-DRG grouper is challenging for some users, so v2023 creates new assignments
       for MDC 14 (obstetrics) based on the diagnosis codes from a MDC 14 code list, in order to allow users to 
	   generate rates.
	 • Users should set the MDC_PROVIDED macro variable to "0" in the CONTROL program
       when MDC is missing or incomplete on the input data. If MDC is available and fully coded, users should
       set the MDC_PROVIDED macro variables to "1". If users set the MDC_PROVIDED macro variable to
       "1" in the CONTROL program, but a few MDC values are missing on input data, the software will
       exclude those discharges with missing MDCs. Additionally, if users set the MDC_PROVIDED macro
       variable to "1" in the CONTROL program, but all MDC values are missing on input data, the software
       will output an error message – "ERROR: MDC_PROVIDED = 1 in CONTROL program but all MDC
       values are missing on input data." In this scenario, users should set the MDC_PROVIDED macro variable
       to "0" in the CONTROL program.
     • Different versions of the Medicare Severity-Diagnostic Related Group (MS-DRG) grouper produce
       slightly different results with respect to certain high resource intensity MS-DRGs. Specifically, MSDRGs
       001-019 and 981-989 are classified as "pre-MDC" MS-DRGs, which means that they are
       associated with such high length of stay and/or cost that they supersede the usual assignment of MSDRGs
       within body system or MDC categories. For records assigned to these MS-DRGs, some versions of
       the grouper software retain the MDC that would be assigned based on the principal diagnosis and
       procedure codes, whereas other versions of the grouper software overwrite the MDC assignment with a
       blank, missing, or nonnumeric value such as "PRE." Thus, users MUST PROVIDE the MDC generated
       by the Centers for Medicare & Medicaid Services (CMS) MS-DRG grouper software, without imputing
       or mapping from MS-DRGs. For accurate results, all eligible records should have an MDC between 01
       and 25. For those users who need to construct MDC, please view the documentation and software
       available here: https://www.cms.gov/files/zip/icd-10-ms-drgs-v401-effective-april-1-2023.zip.
     • CMS' MS-DRG grouper software is updated on October 1 of each year, to accommodate new ICD-10-CM/PCS 
	   codes introduced on that date, and it is further updated on any other date when new codes take
       effect. As a result, the grouper software version that worked on discharge records dated between January
       1 and September 30 of any calendar year does NOT work correctly on discharge records dated between
       October 1 and December 31 of the same calendar year. MS-DRG grouper software is designed for
       backward compatibility, based on the discharge date of each record. Therefore, a user who wishes to
       analyze CY 2022 data must use the version 40 (FY 2023) grouper (or later), while a user who wishes to
       analyze CY 2021 data must use the version 39 (FY 2022) grouper (or later). Many errors will result if a
       user applies the version 39 (FY 2022) grouper to data from the last quarter of CY 2022.
- Includes methodology to address COVID-19 discharges. Users have the following options to specify how to 
  handle COVID discharges in the CONTROL program for each module:
	• Option 1: The user can exclude COVID discharges.
	• Option 2 (default): The user can include all discharges, with and without COVID.
	• Option 3: The user can include only COVID discharges.

Measure specific changes are outlined in the AHRQ SAS download page;
PSI - https://www.qualityindicators.ahrq.gov/Downloads/Modules/PSI/v2023/ChangeLog_PSI_v2023.pdf 

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Patient Safety Indicator 17 Software Version SAS v2022
Release date: JULY 2022
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This version of AHRQ's All-Payers version is named SAS QI v2022
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- Added support for fiscal year 2022 code updates dictated by the Centers for Disease Control and Prevention (CDC) National
  Center for Health Statistics (NCHS) and Centers for Medicare & Medicaid Services (CMS)
  These coding changes impact all software modules.
- Modified setnames, labels, and outputs in multiple modules. See log of changes for indicator-by-indicator changes.
- Users must have major diagnostic categories (MDC) assigned for each discharge on their input file. MDCs are used in measure specifications.
  The AHRQ v2022 software no longer imputes MDC as in v2021 since the calculation is error-prone when 
  the correct classification software is not applied to the input data. Different versions of the Medicare 
  Severity-Diagnostic Related Group (MS-DRG) grouper produce slightly different results with respect to certain high 
  resource intensity MS-DRGs. Specifically, MS-DRGs 001-019 and 981-989 are classified as "pre-MDC" MS-DRGs, which means
  that they are associated with such high length of stay and/or cost that they supersede the usual assignment of MS-DRGs
  within body system or MDC categories. For records assigned to these MS-DRGs, some versions of the grouper software retain
  the MDC that would be assigned based on the principal diagnosis and procedure codes, whereas other versions of the grouper
  software overwrite the MDC assignment with a blank, missing, or nonnumeric value such as "PRE." 
  Thus, users MUST PROVIDE the MDC generated by the Centers for Medicare & Medicaid Services (CMS) MS-DRG grouper software, 
  without imputing or mapping from MS-DRGs. For accurate results, all eligible records should have an MDC between 01 and 25. 
  For those users who need to construct MDC, please view the documentation and software available here:
  https://www.cms.gov/files/zip/icd-10-ms-drgs-v391-effective-april-1-2022.zip.
- Users should set the MDC_PROVIDED macro variable to "0" in the CONTROL program when MDC is missing or incomplete on the input data. 
  If MDC is available and fully coded, users should set the MDC_PROVIDED macro variables to "1". 
  If users set the MDC_PROVIDED macro variable to "1" in the CONTROL  program, but MDC values are missing on input data, 
  the software will exclude those discharges with missing MDCs and output an error message – "ERROR: MDC_PROVIDED = 1 in 
  CONTROL program but all MDC values are missing on input data".    
- The AHRQ SAS QI v2022 continues to include methodology to account for COVID-19 discharges for hospital-level indicators. Starting with 
  AHRQ SAS QI v2021 in modules that include hospital-level indicators (IQI, PDI, PSI), the user has the following options to specify 
  how to handle COVID-19 discharges in the CONTROL program for each module: 
	• Option 1: The user can exclude COVID-19 discharges. This is recommended and is therefore the default choice.
	• Option 2: The user can include all discharges, with and without COVID-19. The software will only calculate numerators, denominators, 
	  and observed rates.
	• Option 3: The user can include only COVID-19 discharges. The software will only calculate numerators, denominators, and observed rates.
  COVID-19 User Guidance is available here: https://qualityindicators.ahrq.gov/Downloads/Resources/COVID19_UserNote_July2021.pdf  
  
Measure specific changes are outlined in the AHRQ SAS download page;
PSI - https://www.qualityindicators.ahrq.gov/Downloads/Modules/PSI/v2022/ChangeLog_PSI_v2022.pdf 

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Patient Safety Indicator 17 Software Version SAS v2021.0.1
Release date: SEPTEMBER 2021
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This version of AHRQ's All-Payers version is named SAS QI v2021.0.1
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- Updated PSI17_HOSP_MEASURES.SAS to fix the issue in SAS QI v2021 when Option 1 or Option 3 were selected in 
  the CONTROL program for COVID-19 exclusions and users had 2020 data in their input file. This issue resulted 
  in no COVID-19 diagnosis-based exclusions for 2020 data in IQI, PDI, and PSI hospital-level indicators. 
  This issue is now fixed in SAS QI v2021.0.1 software and COVID-19 diagnosis-based exclusions are accurately 
  accounted for in computing rates with 2020 data when Option 1 or Option 3 are selected in the CONTROL program.
- For more information see previously released document Update to COVID-19 Exclusions in v2021 Software, available here: 
  https://www.qualityindicators.ahrq.gov/Downloads/Resources/SAS_QI_Release_Memo_COVID-19-Fix_v2021.pdf
- Previous Release Notes for v2021 below also apply to v2021.0.1

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Patient Safety Indicator 17 Software Version SAS v2021
Release date: JULY 2021
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This version of AHRQ's All-Payers version is named SAS QI v2021.
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- Added support for fiscal year 2021 code updates dictated by the Centers for Disease Control and Prevention (CDC) National
  Center for Health Statistics (NCHS) and Centers for Medicare & Medicaid Services (CMS)
  These coding changes impact all software modules.
- Modified setnames, labels, and outputs in multiple modules. See log of changes for indicator-by-indicator changes.

Measure specific changes are outlined in the AHRQ SAS download page;
PSI - https://www.qualityindicators.ahrq.gov/Downloads/Modules/PSI/v2021/ChangeLog_PSI_v2021.pdf 

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Patient Safety Indicator 17 Software Version SAS v2020
Release date: JULY 2020
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This version of AHRQ's All-Payers version is named SAS QI v2020.
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- Added support for fiscal year 2020 code updates dictated by the Centers for Disease Control and Prevention (CDC) National
  Center for Health Statistics (NCHS) and Centers for Medicare & Medicaid Services (CMS) through March 31, 2020. 
  The SAS QI v2020 ICD-10-CM/PCS software does not reflect coding updates effective April 1, 2020. 
  These coding changes impact all software modules.
- Modified setnames, labels, and outputs in multiple modules. See log of changes for indicator-by-indicator changes.

Measure specific changes are outlined in the AHRQ SAS download page;

PSI - https://www.qualityindicators.ahrq.gov/Downloads/Modules/PDI/v2020/ChangeLog_PDI_v2020.pdf 

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Patient Safety Indicator 17 Stand Alone Software Version SAS v2019, ICD-10-CM/PCS 
Release date: JULY 2019
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This version of AHRQ's All-Payers version is named SAS QI v2019 ICD-10-CM/PCS. 
 
Because of the transition to ICD-10-CM/PCS, 2018 SAS QI v2019 is the first software to support risk-adjustment using ICD-10-CMS/PCS.
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- Added support for fiscal year 2019 code updates dictated by the Centers for Disease Control and Prevention (CDC) National
  Center for Health Statistics (NCHS) and Centers for Medicare & Medicaid Services (CMS) through March 31, 2020. 
  The SAS QI v2020 ICD-10-CM/PCS software does not reflect coding updates effective April 1, 2020. These coding changes 
  impact all software modules.
- Introduces execution of all the supporting SAS programs from within the PSI17_HOSP_CONTROL.sas program.
- Modified setnames, labels, and outputs in multiple modules. See log of changes for indicator-by-indicator changes.
- SAS program and control file variables were renamed to align the naming with what the module is measuring - changing
  provider to hospital.
- The naming convention for programs for measures focusing on care inside hospitals are referred to as hospital instead of provider. 

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Measure specific changes are outlined in the AHRQ SAS download page;

PDI - https://www.qualityindicators.ahrq.gov/Downloads/Modules/PDI/V2019/ChangeLog_PDI_v2019.pdf 

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Version SAS v2018, ICD-10-CM/PCS (Non-Risk Adjusted)
Release date: JUNE 2018
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This version of AHRQ's All-Payers version is named SAS QI v2018 ICD-10-CM/PCS (Non Risk Adjusted). AHRQ has revised the 
versioning approach with their software tools to better reflect the fiscal year the software tools are released, 
instead of an incremental version number. Hence, the next All-Payers release will not be called v8.0, but instead, will be 
called v2018.
 
Because of the transition to ICD-10-CM/PCS, risk adjustment is not supported in the 2018 SAS 
(or in v6.0 and v7.0 beta SAS software) for ICD-10-CM/PCS. 
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- Added support for fiscal year 2018 code updates dictated by the Centers for Disease Control and Prevention (CDC) National
  Center for Health Statistics (NCHS) and Centers for Medicare & Medicaid Services(CMS).
- Consolidated formats for DIAPHRP and LUNGBIP into THORAIP due to redundancy.
- Suppressed output of NQI 02, Neonatal Mortality rate, pending technical specification review.
- Updated AHRQ Population file to use US Census 'County Population by Characteristics: 2010-2017 Vintage' tables.
  The new population file uses Census estimates for singe year age population to create AHRQ 18+ age bands, This file includes estimates for the 1995 to 2017 period.
  Population data from years 1995-1999 uses a different method for the age group (18 – 24) compared to the population data starting with 2000.

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Version 7.0.1 Beta, ICD-10-CM/PCS
Release date: December 2017
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AHRQ has named this a "beta version" as a signal to users that there may be significant differences
between results obtained when using data and QI software based on ICD-9-CM coding vs. the results 
obtained when using data and QI software based on ICD-10-CM/PCS.
Users should interpret rates using the 7.0 beta version with caution. 
A brief introduction to the differences between ICD-9-CM and ICD-10-CM/PCS 
is available at: https://www.hcup-us.ahrq.gov/datainnovations/BriefIntrotoICD-10Codes041117.pdf
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The v7.0.1 Beta includes updates to the PDI, PQI, and PQI09 modules.
- Added support for the updated area population file for the years 2016 and 2017.
  The population data is used in calculating the denominator of area level indicators.
  The 1995 to 2017 population file is available for download on the AHRQ SAS Software website.
  http://www.qualityindicators.ahrq.gov/Software/SAS.aspx
- Except for the addition of 2016 and 2017 population data, this version is exactly same as SAS QI 7.0 Beta.

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Version 7.0 Beta, ICD-10-CM/PCS
Release date: September 2017
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-  Adds PQI_AREA_CONDITION.sas to calculate diabetes rates for prevention quality indicators across stratifiers.  (PQI)
- Remove unused PDI variables DUALCAT, FIPST, CNTPRDAY, CONGCAT, TRNSFER, TRNSOUT, MAXPR, NOPOUB04, NOPRDAY, ARRY6, ARRY3, PAY2
- Remove unused IQI variables MORT30, DNR, FIPSTCO, FIPST, PSTCO, LOS, POPCAT, DUALCAT, PAY2, TRNSFER, MAXDX, MAXPR, NOPOUB04, NOPRDAY,
     TRNSOUT, CNTPRDAY, ARRY1, ARRY3, ARRY6
- Remove unused PSI variables ASOURCE, FIPSTCO, FIPST, and PSTCO, POPCAT, DUALCAT, MAXDX, MAXPR, NOPOUB04, NOPRDAY, TRNSOUT, TRANSFER
     PAY2, CNTPRDAY, ARRY1, ARRY3, ARRY4, ARRY6
- Remove unused PQI variables DUALCAT, PAY2, POVCAT1-POVCAT10, FEMALE, PVIDX, AGECAT1-AGECAT14, FAGECAT1-FAGECAT14, ARRY1, ARRY2, ARRY3
- Added support for ICD Version 34 and MS-DRG Version 34 codes through 09/30/2017
- Remove measures from version 7.0.
    IQI 23 Laparoscopic Cholecystectomy Rate
    IQI 24 Incidental Appendectomy in the Elderly Rate
    IQI 25 Bilateral Cardiac Catheterization Rate
    IQI 26 Coronary Artery Bypass Graft (CABG) Rate
    IQI 27 Percutaneous Coronary Intervention (PCI) Rate
    IQI 28 Hysterectomy Rate
    IQI 29 Laminectomy or Spinal Fusion Rate
    PSI 21 Retained Surgical Item or Unretrieved Device Fragment Rate 
    PSI 22 Iatrogenic Pneumothorax Rate 
    PSI 23 Central Venous Catheter-Related Blood Stream Infection Rate 
    PSI 24 Postoperative Wound Dehiscence Rate
    PSI 25 Unrecognized Abdominopelvic Accidental Puncture or Laceration Rate 
    PSI 26 Transfusion Reaction Rate 
    PSI 27 Postoperative Hemorrhage or Hematoma Rate

- Added exclusion for cases in hospice care at admission where POINTOFORIGINUB04 equal to 'F'.  (applicable to: IQI 15-20; PSI 04).
- Add support for present on admission exemption diagnosis codes based on date of discharge.

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Measure specific changes are outlined in the AHRQ SAS download page;

PQI - https://www.qualityindicators.ahrq.gov/Downloads/Modules/PQI/v2018/ChangeLog_PQI_v2018.pdf

IQI - https://www.qualityindicators.ahrq.gov/Downloads/Modules/IQI/v2018/ChangeLog_IQI_v2018.pdf

PSI - https://www.qualityindicators.ahrq.gov/Downloads/Modules/PSI/V2018/ChangeLog_PSI_v2018.pdf 

PDI - https://www.qualityindicators.ahrq.gov/Downloads/Modules/PDI/V2018/ChangeLog_PDI_v2018.pdf 
