Case 2010-MDC14-02 Abortion by Caesarean section
|Target version:||Expert Group 2010|
|MDC:||MDC14||Owner / responsible:|
|Target Grouper:||COMMON||Old forum status:||CLOSITEM - Closed item|
Last updated: 2010-04-09
Status: CLOSITEM - Closed item
By: email@example.com, Stockholm/CPK, Sweden
Expert Network 2010-03-12 - Change recommended
Board 2010-04-09 - Recommendation accepted
CPK ID 336
We had a case with a late legal abortion, O04.9 (Legal abort, komplett eller icke specificerad utan komplikation) that ended up with a Caesarean section, MCA96 (Annat kejsarsnitt). The grouping result was DRG 380 (Abort utan evakuering) which is remarkable. One could expect DRG 381 (Abort med evakuering eller hysterotomi).
Analysis by CPK
This situation must be very rare because there were no cases with a principal diagnosis for legal abortion (codes O04) combined with Caesarean section (codes MCA) in DRG 380 in the Swedish cost database for 2008. Thus, we have no cost data but it is obvious that a Caesarean section cannot be less expensive than an evacuation procedure. The Swedish weights (2010) are:
Suggestion by CPK
It is logical, both medically and economically, that legal abortion that ends up with a Caesarean section (= hysterotomy) is grouped to DRG 381. This is easily achieved by adding the procedure property 14S05 to the present properties for the codes for Caesarean section, which are:
Expert Network 2010-03-12
The meeting recommended creating a rule for MCA96 which in this situation will leads to DRG 470. This is a wrong coding. Procedure LCH20 Hysterotomi should be using.
A new rule is created before current rule ORD 400D70102. It is a copy of the current rule but Procprop is given value 14S01, Dgprop1 14X31 and DRG is changed to 470.
Cases with Caesarean section and abortion are assigned to DRG 470.
Correct coding of "sectio minor" is LCH20 (LCXH20).