Case 2011-MDC07-01 Revision of rules for the cholecystectomy DRGs
|Target version:||Expert Group 2012|
|MDC:||MDC07||Owner / responsible:|
|Target Grouper:||Old forum status:||CLOSITEM - Closed item|
Last updated: 2012-03-19
Status: CLOSITEM - Closed item
By: Helsedirektoratet, Norway
Expert Network 2011-03-17 - Change recommended
Board 2011-04-04 - Recommendation accepted
Expert Network 2012-03-08 - Proposal rejected
Board 2012-03-19 - Recommendation accepted
All DRGs for cholecystectomy require MDC to be 07. This is a fairly robust solution, but leads to the exclusion of some cases. For instance, ICD-10 O996 “Diseases of the digestive system complicating pregnancy, childbirth and the puerperium” is a proper code for bile bladder problems during pregnancy, but belongs to MDC 06. Cases with O996 as principal dx thus can not be grouped to the cholecystectomy DRGs.
We find that a simple solution to the problem would be to change the rules for the cholecystectomy DRGs so that MDC 07 is no longer mandatory.
MDC should be changed from 07 to nothing in all rules for the cholecystectomy DRGs.
Expert Network 2011-03-17
The meeting recommended acceptance of the proposal and create a principal diagnosis special rule for O99.6.
The case will be closed.
Technical change 2011-03-28
New principal diagnosis property 07P01 ‘Liver and biliary tract problem’.
The dx 099.6 is given the new property 07P01.
All rules from current ord 407D0201 to current ord 407D121 and from current ord 107D0200 to current ord 107D1310 are dublicated. The copy is placed immediately after current rule and on each line the mdc is removed and principal diagnosis property is given value 07P01 and sex F.
DRG change 2011-03-28
Cases with dg O99.6 are assigned to hepatobiliary drg’s if a hepatobiliary procedure is performed. Without intervention the cases are assigned to gastrointestinal conservative DRG’s.
NPK, Mats Fernström and Martti Virtanen, 2011-05-06
This case is reactivated. The planned changes will not be done 2012.
It has been difficult to distinguish liver and gastrointestinal problems with the code O99.6 and therefore it is necessary to discuss it further next year.
Expert Network 2012-03-08
The meeting recommended rejecting the proposal.
O99.6 doesn´t show what type of problem that is concerned. The code includes among other things biliary tract diseases, hepatological diseases, gallbladder problems and so on. This means that there are no easy solution for this problem right now. For Sweden it might be a solution to create subcodes that can be given different grouping properties.
The case will be closed.