Case #185

Case 2010-MDC14-02 Abortion by Caesarean section

Added by Anonymous about 7 years ago.

Status:AcceptedStart date:2014-01-15
Priority:NormalSpent time:-
Assignee:-
Category:-
Target version:Expert Group 2010
Initiator:Sweden Target year:2011
MDC:MDC14 Owner / responsible:
Target Grouper:COMMON Old forum status:CLOSITEM - Closed item

Description

Last updated: 2010-04-09
Status: CLOSITEM - Closed item
Initiated: 2010-01-14
By: , Stockholm/CPK, Sweden
Expert Network 2010-03-12 - Change recommended
Board 2010-04-09 - Recommendation accepted

BACKGROUND

CPK ID 336

Problem

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:

COMMENTS

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.

CHANGES

Technical change

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.

DRG change

Cases with Caesarean section and abortion are assigned to DRG 470.

Correct coding of "sectio minor" is LCH20 (LCXH20).

Introduction

2011

2010-MDC14-02_01.jpg (10.1 KB) Anonymous, 2014-01-15 12:31

2010-MDC14-02_02.jpg (15 KB) Anonymous, 2014-01-15 12:31

Also available in: Atom PDF