ICD9-CPT Crosswalk UR Advisor (explanation of columns/fields)
Column/Field	Explanation
ICD9 Code	ICD9 primary diagnosis code on the claim, with the primary code selected as the "most severe" diagnosis per ODG when there are multiple diagnosis codes in a claim.  Also includes higher level codes, e.g., data for 722.10 also included at 722.1 and 722.
ICD9 Name	Official ICD9 name
CPT Code	CPT Procedure Code approved and paid, for a claim with this ICD9 diagnosis code.  CPT copyright & trademarked AMA.
CPT Name	CPT Code description
Incidence Rate per 100,000 Workers	Number of WC claims with this primary ICD9 code and this CPT code per 100,000 workers per year in the U.S.
% CPT Frequency for ICD9	Percent of claims with this primary ICD9 code that also have this CPT code.
Visits 25th %	Number of units billed for this CPT code by quartile, for all claims with this primary ICD9 code.  25% of claims had this number or less.
Visits 50th %	Number of units billed for this CPT code by quartile, for all claims with this primary ICD9 code.  50% of claims had this number or less.
Visits 75th %	Number of units billed for this CPT code by quartile, for all claims with this primary ICD9 code.  75% of claims had this number or less.
Visits Mean	Average number of units billed for this CPT code, for all claims with this primary ICD9 code.
Costs Mean	Average costs per claim for all instances of this CPT code used for this ICD9 code.  Note:  This is not cost per CPT code unless that CPT code were only used once, on average.
ODG CAA	From ODG Treatment, Codes for Automated Approval, Maximum Occurrences.
Bill Review Payment Flag	Used to automate UR decisions
Green	Green = OK to auto-pay up to ODG CAA max number of visits [defined by appearing in ODG TWC Codes for Automated Approval]
Yellow	Yellow = May be OK to pay up 25th percentile (or 50th depending on policy) number of visits [defined by either (1) Frequency over 10% & Incidence over .05, or (2) Frequency over 2% & average total cost per claim under $200 for all use of this CPT code in the claim & Incidence over .03, or (3) Frequency over 1% & average total cost per claim under $50 for all use of this CPT code in the claim & Incidence over .01]
Red	Red = Need to review [defined by not selected above]
Black	Black or Not listed = Not approve [(1) Not listed = should never happen, or (2) Black = Incidence Rate less than .10 & Frequency under 2%, meaning should be very rare]