Case #158

Case 2011-MDC07-02 Merge DRG 199 ”Diagnostisk operasjon på lever/ galleveier/ bukspyttkjertel m/ ondartet svulst” with DRG 200 ”Diagnostisk operasjon på lever/ galleveier/ bukspyttkjertel u/ ondartet svulst”

Added by Anonymous about 7 years ago.

Status:RejectedStart date:2014-01-08
Priority:NormalSpent time:-
Assignee:-
Category:-
Target version:Expert Group 2012
Initiator:Norway Target year:
MDC:MDC07 Owner / responsible:
Target Grouper: Old forum status:CLOSITEM - Closed item

Description

Last updated: 2012-03-19
Status: CLOSITEM - Closed item
Initiated: 2011-02-18
By: Helsedirektoratet, Norway
Expert Network 2011-03-17 - Postpone recommended
Board 2011-04-04 - Recommendation accepted
Expert Network 2012-03-08 - Proposal rejected
Board 2012-03-19 - Recommendation accepted

BACKGROUND

DRG 199 and DRG 200 have relatively few cases in Norway, respectively 90 and 30 cases for 2010 (approximate figures).

In addition to this, our calculated costs weights show that the DRG without malignant tumor (DRG 200) will have higher weight than the DRG (199) with malignant tumor.

Proposal

We suggest to merge DRG 199 with DRG 200 into one DRG; ”Diagnostisk operasjon på lever/galleveier/bukspyttkjertel”.

Technical changes

The implementation is simple. The one and only rule for DRG 199 is removed, thereby causing all cases to be catched by the present rule for DRG 200. The DRG should be given a new code.

COMMENTS

Expert Network 2011-03-17

The meeting recommended still postponing the case for further investigation and costs data and also result from the CC-grouper by Sweden.

Expert Network, 2011-10-27

The meeting recommended still further investigation of the result from the CC-grouper by Sweden.

Expert Network 2012-03-08

The meeting recommended rejecting the proposal.

Swedish KPP shows that the costs between these DRG are quite big. These dependents on that the procedures done varies a lot. The secondary diagnosis also contributes to the cost increase.

The case will be closed.

Also available in: Atom PDF