Case #192

Case 2010-MDC23-01 The Z-diagnoses in MDC23

Added by Anonymous almost 8 years ago. Updated over 7 years ago.

Status:AcceptedStart date:2009-12-03
Priority:MajorSpent time:-
Target version:Expert Group 2011
Initiator:Sweden Target year:2012
MDC:MDC23 Owner / responsible:Nordic Casemix Centre
Target Grouper:COMMON, DEN, EST, FIN, ICE, LAT, NOR, SWE Old forum status:CLOSITEM - Closed item


Last updated: 2011-04-20
Status: CLOSITEM - Closed item
Error corrected by Nordic Centre
Initiated: 2009-12-03
By: Mats Fernström, CPK, Sweden
Expert Network 2010-03-12 - Change recommended
Board 2010-04-09 - Recommendation accepted
Expert Network 2011-03-17 - Correction recommended
Board 2011-04-04 - Recommendation accepted


CPK ID 330


The Z-diagnoses in MDC 23 are a very heterogeneous group and clinically some of them certainly should belong to more specific MDCs.


We have judged the Z-diagnoses in MDC 23 from a clinical perspective and suggest some changes. See the attached Excel-file (CPK ID 330 Appendix.xls).
Some of the suggestions are marked with ?. In these cases we are not sure and we want the NordDRG expert group to have a principal perspective on some issues. Is it OK to allocate healthy persons to MDCs for specific diseases? At least it might be delicate to allocate them to MDC 19.

Some issues for a principal discussion are:

  • Vaccinations, (in the range Z230 - Z279)
  • Diseases in the family history, (in the range Z800 - Z848)
  • Diseases in the personal history, (in the range Z860 – Z929)
  • Acquired absence, (in the range Z890 - Z908)
  • Presence of artificial openings, (in the range Z930 - Z982)
  • Presence of implants or devices, (in the range Z950 - Z982)


Expert Network 2010-03-12

The meeting recommended the changes according the revised table Z-codes_to_be_removed_from_MDC_23.


Technical change

The 162 diagnosis (Swedish version) are moved to the rest group diagnosis category of the MDC listed in the table Z-codes removed from MDC23 (xxM99).

DRG change

Cases with these dx as principal diagnosis are assigned to organ specific DRG’s instead of MDC 23.




Mats Fernström, CPK 2011-01-21

In the Swedish version of NordDRG 2011 there has been correctly reported from the swedish health care that the following codes are not just for women bur also for men:

  • Z30.8 Annan födelsekontroll
  • Z30.9 Födelsekontroll, ospecificerad
  • Z31.4 Fertilitetsundersökning
  • Z31.6 Allmän fertilitetsrådgivning
  • Z31.8 Annan fertilitetsfrämjande åtgärd
  • Z31.9 Fertilitetsfrämjande åtgärd, ospecificerad

This means that all of these codes should have the following properties:

  • DGCAT 98M99
  • MDC 98
  • DGPROP 98X99

Mats Fernström, NPK 2011-03-04

The error mentioned in the comment above (2011-01-21) has been corrected in the final Swedish version of NordDRG for 2011.

For information we will also report that we noticed another error with connection to this case. Control visits after delivery were incorrectly grouped to DRG 373O (Vaginal förlossning, öppenvård). This error has also been corrected in the final Swedish version of NordDRG for 2011 by removal of all the rules with the combinations of the diagnosis properties 14X02 + 14X04 and 14X02 + 14X05.

Expert Network 2011-03-17

The meeting recommended acceptance of the correction.

Z30.1, Z30.4 and Z30.5 should have in MDC13 and not in MDC14.

The case will be closed.

Fredrik A.S.R. Hanssen, Norway 2011-03-18

The following codes were given DGCAT 14M99, but they should have been assigned to DGCAT 13M99 since these diagnoses are not obstetrical but gynecological:

  • Z301 Kontakt med helsetjenesten for innsetting av spiral
  • Z304 Kontakt med helsetjenesten for overvåkning av befruktningshindrende legemiddel
  • Z305 Kontakt med helsetjenesten for kontroll av spiral

These changes should be included in the common nordic version for 2012, according to the expert meeting recommendation 18 Mar 2011. The changes should also be applied to the Norwegian version for 2011, according to the correction letter sent by email 11 Mar 2011.

CPKID_330_Appendix.xls (138 KB) Anonymous, 2014-01-16 12:34

Z-codes_to_be_removed_from_MDC_23.xls (52 KB) Anonymous, 2014-01-16 12:34


#1 Updated by Anonymous over 7 years ago

  • Start date changed from 2014-01-16 to 2009-12-03
  • Priority changed from Normal to Major
  • Status changed from Active to Accepted
  • Owner / responsible Nordic Casemix Centre added

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