Case #134

Task #11: Delivery of minor update proposals for NordDRG 2015

Case 2012-MDC10-02 Error correction DRG 288B

Added by Anonymous over 5 years ago. Updated about 4 years ago.

Status:AcceptedStart date:2013-12-20
Priority:Error correctionSpent time:-
Assignee:Martti Virtanen
Category:-
Target version:Expert Group 2014
Initiator:Finland, Iceland Target year:2015
Case type: Owner / responsible:Nordic Casemix Centre
MDC:MDC10 Old forum status:
Target Grouper:FIN, ICE

Description

Last updated: 2012-11-01
Initiated: 2012-06-29
By: National DRG Centre in Finland / Petra Kokko, Minna-Liisa Sjöblom

Problem
Unexpected grouping of a case and possibility to similar groupings

Following case:
Diagnoses:

  • E0420 Nontoxic multinodular goitre
  • D2240 Benign neoplasm of melanocytic naevi of scalp and neck

Procedures:

  • BASA40 Unilateral lobectomy of thyroid gland
  • QASE80 Excision of other lesion extending through all layers of skin in head or neck
In an inpatient case results in DRG
  • 288B Other procedure for obesity

Analysis

This grouping is because obesity and thyroid problems are counted as endocrine problems (MDC 10) and thre rule for DRG 288B is before the rule for DRG 290X 'Thyroid procedures'. The intervention QASE00 is for D2240 and not for the thyroid problem. Although it is not an OR-procedure together with BASA40 it is counted. The property 10S04 'OR procedure for obesity' thus fullfills the rule for DRG 288B.
All procedure codes linked to QxSE80 'Excision of other lesion extending through all layers of skin in...' (QxE10) and QxSE82 'Excision of other superficial lesion of skin from head and neck...' (Qxe15) would behave similarly.

Suggestion

Procedure codes linked to QxSE80 'Excision of other lesion extending through all layers of skin in...' and QxSE82 'Excision of other superficial lesion of skin from head and neck...' should not have 10S04 property.

Comments

Martti Virtanen 2014-01-28

This proposal seems to have been lost on the track, it has never been discussed.

The case is basicly for Finland only and therefore earlier partly only in Finish. I have translated the texts and clarified the original proposal.

The problem is valid but the solution needs discussion. QxSE80 and QxSE82 codes are used only in Finland and Iceland. Other use either QxSE02 'Excision of loose normal skin or fold of skin from head and neck'(to which QxE00 is mapped)or QxSE99 'Other excision or repair of skin of head or neck' (to which QxE99 is mapped). QxSE02 codes have 10S04 whereas QxSE99 codes do not have that property. Since in Sweden for example the text for QAE00 is 'Hudexcision i huvud-halsregion' i.e. 'Skin excision in ...' and QAE99 'Annan excision eller rekonstruktion i huvud-halsregion' i.e. 'Other excision or reconstruction in ...' it is unclear how these codes are used.

For Finland and Iceland the proposed change solves the problem. For other countries the coding practice and possibly codes in the QxSE area should be reconsidered.

Comment Expert Group 2014-03-24

Discussion is needed about all the mapping of the properties of this group. Change only in Finnish and Icelandic version. Changes in other national versions will be discussed as a new case.

History

#1 Updated by Martti Virtanen about 5 years ago

  • Description updated (diff)
  • Old forum status changed from CLOSITEM - Closed item to ACTITEM - Active item
  • Target year 2015 added
  • Initiator Iceland added

#2 Updated by Anonymous about 5 years ago

  • Target version set to Expert Group 2014
  • Old forum status deleted (ACTITEM - Active item)
  • Target Grouper COMMON, DEN, EST, FIN, ICE, LAT, NOR, SWE added

#3 Updated by Anonymous about 5 years ago

  • Priority changed from Normal to Error correction

#4 Updated by Anonymous about 5 years ago

  • Description updated (diff)

#5 Updated by Anonymous about 5 years ago

  • Assignee set to Martti Virtanen

#6 Updated by Anonymous about 5 years ago

  • Case type deleted (Error correction)

#7 Updated by Anonymous about 5 years ago

  • Parent task set to #11

#8 Updated by Anonymous almost 5 years ago

  • Description updated (diff)
  • Target Grouper deleted (COMMON, DEN, EST, LAT, NOR, SWE)

#9 Updated by Anonymous almost 5 years ago

Comment Expert Group 2014-03-24

Error correction and change only for Iceland and Finland.
Proposal like this accepted.

#10 Updated by Martti Virtanen almost 5 years ago

2014-03-26 Martti Virtanen

Technical change:
NCSP+ codes of the type QxSE80 and QxSE82 and national codes linked to these codes (ICE and FIN) will loose the property 10S04

DRG change:
The cases with these interventions will not be assigned to DRG 288B 'Other procedure for obesity'. If these interventions are the only intervention and the pricipal dx is from MDC 10, the cases will be assigned to DRG 477. If other interventions have been peformed they will define the DRG.

#11 Updated by Anonymous about 4 years ago

  • Status changed from Active to Accepted

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