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AHRQ’s POA-exempt lists differ for every fiscal ICD version #47

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@dewittpe

AHRQ’s POA-exempt lists differ for every fiscal ICD version examined (ICDVER 33–43, approximately FY2016–FY2026).

A clear status change is Z515:

  • V33: exempt
  • V34–V38: not exempt
  • V39–V43: exempt again

Most other differences reflect code-set revisions rather than policy reversals—for example, a parent code is removed and replaced by more-specific child codes. Among currently mapped Elixhauser codes, 32 show list variation, primarily
patterns such as:

  • I6931 removed when I69310–I69319 were introduced.
  • Q238 replaced by Q2381, Q2382, and Q2388.
  • Z9115 replaced by more-specific codes.

Therefore, medicalcoder’s unioned poaexempt flag is not semantically identical to AHRQ’s fiscal-version-specific lookup. The practical effect may be limited for annual methods because code mappings also change, but it can affect
continuously valid codes and the cross-version elixhauser_ahrq_icd10 method. AHRQ explicitly selects exemptions by ICDVER in its data-raw/elixhauser/ahrq/CMR_Mapping_Program_v2026-1.sas:248, while medicalcoder collapses them into one union
in data-raw/elixhauser/elixhauser_ahrq_icd10.R:195.

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