Case #127

Case 2012-MDC05-01 FNG10 Embolectomy from coronary arteries

Added by Anonymous over 7 years ago.

Status:AcceptedStart date:2013-12-20
Priority:NormalSpent time:-
Assignee:-
Category:-
Target version:Expert Group 2012
Initiator:Sweden Target year:2013
MDC:MDC05 Owner / responsible:Nordic Casemix Centre
Target Grouper:COMMON, DEN, EST, FIN, ICE, LAT, NOR, SWE Old forum status:CLOSITEM - Closed item

Description

Last updated: 2012-03-19
Status: CLOSITEM - Closed item
Initiated: 2011-11-11
By: Liselotte Säll ()
Expert Network 2012-03-08 - Changed recommended
Board 2012-03-19 - Recommendation accepted

BACKGROUND
CPK ID: 405

Problem:

In Sweden there has occurred a question about the fact that FNG10 Embolectomy from coronary arties leads to DRG E15A, E15C, E15E, E15O Other cardiothoracic surgeries, Major complicated, complicated, uncomplicated (Andra kardiotorakala operationer) (Earlier DRG 108) instead of DRGs concerning PCI: The PCI DRGs involved are E19N, E19O, E18C, E18E PCI (Earlier DRG 112A, C, D, E, F, O).
FNG10 is not a difficult surgical procedure (mostly percutaneous) and should not be grouped to a DRG concerning cardiothoracic surgeries but should be grouped like FNG05 PTCA since it can be done at the same time as FNG10.

Analysis by NPK, Sweden:

In a medical perspective and also looking at costs, FNG10 is better placed in DRG E19E, E18C and E18E.

Suggestion by NPK, Sweden:

In a medical perspective and also looking at costs FNG10 is better placed in DRG E19E, E18C and E18E.
To achieve this Sweden suggest that FNG10 has PROCPR 05S06 changed to PROCPR 05S25. FNG10 should also loose PROCPR 99S90.
For technical changes see TECHNICAL CHANGES SWE 2012-02-17.xls

COMMENTS

Martti Virtanen, NCC 2012-02-28:

I support this idea.
The situation is created by the irregularity in NCSP. FNSG10 is structured as code for open intervention, which it almost never is. In Danish and Icelandic versions of NCSP there exists a separate code for percutaneous procedure. However, it is quite unlikely that this intervention would any more be done as an open intervention.
99S90 is a property that is automatically added if the procedure property indicates extensive interventions (ext =1). 05S06 has property ext=1 wheras 05S25 does not have it. The proposed change will remove also 99S90.

Expert Network 2012-03-08:

The meeting recommended accepting the proposal.
The change is to remove procprop 05S06 and add procprop 05S25 to procedure FNSG10. With this change will procprop 99S90 automatically disappear.
The case will be closed.

Introduction:

NordDRG 2013

MDC05-01.jpg (31.5 KB) Anonymous, 2013-12-20 11:44

TECHNICAL_CHANGES_SWE_2012-02-17.xls (76.5 KB) Anonymous, 2013-12-20 11:55

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