Episode of Care Definitions

The List of Episodes is available for all users who are interested in reviewing it; the Episodes of Care Definition Summary Descriptions are made available to the licensees and partners of PROMETHEUS Analytics. The summary descriptions are designed to facilitate understanding of the scope and boundaries of a specific episode.

Summary Descriptions
When using the definitions summaries, it is important to understand the distinction between the clinical code sets that define an episode from service assignment and other rules that are required to build episodes. These rules have been defined within the PROMETHEUS Analytics system and are available only by licensing the software or through certified partners of PROMETHEUS.

The Episodes of Care Definitions provide a brief description and the episode’s intent along with all applicable codes—Triggers, Sub Types, Relevant Diagnoses, Relevant Procedures, and Pharmacy codes. Our current dataset include both ICD9 and ICD10 codes. The codes are reviewed and updated on a regular basis.

If you have the password to access the definitions, please enter it after selecting the episode version you are interested in reviewing. If you do not have a password, the PROMETHEUS licensee you work with can provide it, or contact us using the ‘CONTACT’ link on top of the page. Please provide as much information as possible to help us validate your access request. Thank you.

Episode Analytics to Guide Your Value-Based Care Transition

A value-based payments analytics platform designed for health plans that want to foster deep clinical and cost analysis through episodic claim grouping and network analysis.

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