Step 1: Standard Weights

The EDC Analyzer™ reviews all reason for visit diagnosis codes and assigns a Proportional Standard Cost Allocation (PSCA) and associated standard weight to each code based on the age and sex* of the patient. If multiple PSCAs are assigned to a claim, the EDC Analyzer™ takes the highest PSCA found. There are five possible PSCAs corresponding to the five ED visit levels:

PSCA Values

PSCA Description
1 (lowest weight) Presenting problem is self-limited or minor
2 Presenting problem is low to moderate severity
3 Presenting problem is moderate severity
4 Presenting problem is high severity, requiring urgent evaluation
5 (highest weight) Presenting problem is high severity, posing an immediate, significant threat to physiological function

Standard weights were calculated by analyzing the typical amount of facility resources utilized for each presenting problem which includes the following:

  1. Nursing and ancillary staff time (for a routine arrival, triage, registration, basic patient/family communications, and a routine discharge)

  2. The room

  3. Creation of a medical record

  4. Coding and billing

Step 1 Examples

Presenting Problem Diagnosis Code Age Range Sex* Standard Weight**
Blood pressure check Z01.30 > 2 M & F ***
Weakness R53.1 > 2 M & F ****
Seizure: pregnant O15.9 7 – 54 F ****
Fever R50.9 2 – 74 M & F ***
Fever R50.9 75+ M & F ***
Wheezing R06.2 2 – 11 M & F ***
Wheezing R06.2 12+ M & F ****
*Patient sex assigned at birth