ICD-10 Focused Populations (Historical)

For patient discharges beginning 10/1/2020

QualityAdvisor maintains two versions of the CMS defined focused populations (Current and Historical). As new CMS defined focused population definitions are implemented in the application each year, the Historical CMS defined focused population definitions are rolled off the application* and replaced with what was the Current definition. The Historical definition remains available for reporting purposes until the next fiscal year CMS defined focused population definitions are implemented, if applicable.
*Note: There may be various Historical fiscal year definitions available on this page to accommodate situations when no new versions of populations are implemented for the new fiscal year.

Note: Unless the population definition specifies principal diagnosis and/or procedure, the first 25 ICD codes are considered when patients are grouped to a focused population in QualityAdvisor.

Refer to the CMS Readmission and Mortality, and Premier-Defined Populations (Historical) ICD-10 Code Appendix/Tables as of April 2025

If there are no changes made to a specific population when a new ICD-10 Code Appendix/Tables list is implemented, the existing version of the population remains in the Current folder and the existing Historic version for the population remains in the Historic folder.

The following Focused Populations are available:

Type of Population	ICD-10 Population Algorithms
CMS Readmission and Mortality Populations*	Acute Myocardial Infarction (FY23—FY25) Chronic Obstructive Pulmonary Disease (COPD) (FY20 - FY22) Coronary Artery Bypass Graft (FY24—FY25) Heart Failure (FY24—FY25) Pneumonia (FY24—FY25) Total Hip Arthroplasty and/or Total Knee Arthroplasty (FY25)
CMS Mortality Populations*	Stroke (FY21 - FY22)

*Note:The CMS Readmission and Mortality focused populations are provided to narrow populations to a clinical condition and closely align to Yale’s definition for the payment programs.  However, since QualityAdvisor’s use of a focused population can span beyond the scope of a 30-day readmission or mortality calculation, Premier made certain allowances to maximize the patient population beyond these measures.  In other words, the focused populations within QualityAdvisor can be used for metrics not limited to the readmission or mortality outcome.  To more closely align with the CMS measure specifications for the focused populations, it may be necessary to apply additional filter criteria via the reporting prompts to narrow your population further (i.e. age, payer, and discharge status).

Excluded Populations

The following populations are excluded from being grouped:

• Skilled Nursing

• Long Term Care

• Rehab

• Hospice

• Same Day Surgery

• Emergency

• Observation

• Diagnostic Testing

• Recurring/Series

• Pre-Surgical Testing

• Home Health

• Clinic

• Organ Donor