Case #167
Case 2010-MDC03-01 Hierarchy problem in MDC 03
| Status: | Accepted | Start date: | 2014-01-13 |
|---|---|---|---|
| Priority: | Normal | Spent time: | - |
| Assignee: | - | ||
| Category: | - | ||
| Target version: | Expert Group 2010 | ||
| Initiator: | Sweden | Target year: | 2011 |
| MDC: | MDC03 | Owner / responsible: | |
| Target Grouper: | COMMON, DEN, EST, FIN, ICE, LAT, NOR, SWE | Old forum status: | CLOSITEM - Closed item |
Description
Last updated: 2010-04-09
Status:CLOSITEM - Closed item
Initiated: 2010-01-14
By: Susan.Bengtsson@aleris.se/CPK, Sweden
Expert Network 2010-03-12 - Change recommended
Board 2010-04-09 - Recommendation accepted
BACKGROUND
CPK ID 331
Problem
An adenoidectomy or tonsillectomy in outpatient care is allocated to DRG 060O (Operations on tonsils or adenois, short therapy) with the weight 0,1909 (Sweden 2010). If an excision of a lesion of the lip (EAA10) is done in the same session the case is allocated to DRG 169O (Mouth procedures, short therapy) with the weight 0,1111. Thus, the addition of a secondary procedure results in a DRG with lesser weight. This is undesirable because we have a risk for underreporting of procedures, which will lead to incorrect medical registers.
Analysis
The weights in question are based on a large number of observations and seem to be OK. The problem is caused by a hierarchy problem in the outpatient part of MDC 03.
Suggestion
The rule for DRG169O with ORD 103D0100 should be moved to below the last rule for DRG 060O.
COMMENTS
Expert Network 2010-03-12
The meeting recommended accepting the proposal to move the rule for DRG169O with ORD 103D0100.
CHANGES
Technical change
The rule for DRG 169O (currently ORD 103D0100) is moved to ORD 103D15900 (after DRG 060O).
DRG change
Cases with both procedures for DRG 060O and 169O are assigned to DRG 060O.
Introduction
2011