The Complex Chronic Conditions (CCC) are groupings of International Classification of Diseases (ICD) codes that Chris Feudtner, MD, PhD, MPH, and colleagues developed in 2000 to identify patients with "any medical condition that can be reasonably expected to last at least 12 months (unless death intervenes) and to involve either several different organ systems or one organ system severely enough to require specialty pediatric care and probably some period of hospitalization in a tertiary care center."
The algorithm can be used to identify children with a particular CCC category or to identify patients with multiple CCC categories, including:
- Cardiovascular
- Neurologic or neuromuscular
- Malignancy
- Congenital or genetic
- Respiratory
- Neonatal
- Hematologic or immunologic
- Renal
- Metabolic
- Gastrointestinal
- Transplant
New in CCC Version 3:
- The above categories are initially assigned using non-technology dependent ICD diagnosis and procedure codes. However, if a patient has any of these categories identified, then ICD procedure codes are examined to determine if the patient has technology dependency in any of the categories. Technology dependency in a new category will alter the category's indicator. For example, if a patient has only a cardiovascular CCC identified using non-technology dependent codes, but is identified as having renal technology dependency, the renal CCC will be altered to 1.
- Category specific technology dependency indicator variables are now available (e.g., cvd_tech, gi_tech).
- Categories and subcategories can be requested to add to each ICD diagnosis and procedure code (e.g., dxcat1, dxcate2, prcat1, prcat2).
For Epic EHR customers: Cincinnati Children’s has developed an Epic Turbocharger package that allows real-time assessment of a patient’s Complex Chronic Conditions (v3.0) in their problem list via columns in patient lists and Reporting Workbench. The groupers can also be used to query local databases for historic data. The package is easy to implement with the help of a local Epic Analyst. If you are interested in this package, please contact melanie.cole@cchmc.org to learn more and request the packaged XML files.
