Running a Pfadfinder Analysis
This guide walks you through submitting a case for Pfadfinder analysis and interpreting the results.
Starting an Analysis
- Open the Pfadfinder tab in your workspace.
- Enter the case data:
- Principal diagnosis (HD) — The main ICD-10-GM code.
- Secondary diagnoses (ND) — Additional ICD-10-GM codes.
- Procedures — OPS codes with dates.
- Patient data — Age, gender, length of stay, ventilation hours (if applicable).
- Click Analyze to start the Pfadfinder process.
Understanding the Results
Pfadfinder presents its findings in several sections:
Current Grouping
The top section shows the DRG result based on your current codes — the same result you would get from the Grouper tab.
Recommended Paths
Below the current grouping, Pfadfinder lists alternative coding scenarios ranked by impact:
- Scenario description — What codes would change and why.
- DRG comparison — The resulting DRG vs. the current DRG.
- Weight difference — The change in relative cost weight.
- Confidence — How confident Pfadfinder is in the recommendation.
- Rationale — The clinical and coding logic behind the suggestion.
Code Suggestions
For each recommended path, Pfadfinder may suggest specific codes to add, change, or remove:
- Green (Add) — A code that could be added based on available documentation.
- Yellow (Review) — A code that may need clinical review or additional documentation.
- Red (Remove) — A code that may not be supported by the documentation.
Acting on Results
After reviewing the analysis:
- Click Apply on a recommended path to transfer the suggested codes to the Grouper tab.
- Click Dismiss to hide a recommendation you have reviewed and decided not to apply.
- Click Export to download the full analysis report.
Tips for Better Results
- Include all known diagnoses and procedures, even if you are unsure about some.
- Provide accurate patient demographics — age and gender affect many DRGs.
- Include ventilation hours and ICU days when applicable, as these influence grouping for many surgical DRGs.