Case 2009-MDC23-01 DRG 462 and 462O for rehabilitation
|Target version:||Expert Group 2009|
|MDC:||MDC23||Owner / responsible:|
|Target Grouper:||Old forum status:||CLOSITEM - Closed item|
Last updated: 2009-03-20
Status: CLOSITEM - Closed item
By: CPK, Sweden
Expert Network 2009-02-26 - Proposal rejected
Board 2009-03-20 - Recommendation accepted
CPK ID 276
In NordDRG 2009 rehabilitation for In-patients goes to DRG 550A-560E, Case 2006-MDC23-01 [[http://documents.norddrg.net/issues/195]] but DRG 462 and 462O are still there. If any of the diagnosis codes below is used as main condition the result is DRG 462/462O.
In EKT´s new recommendations 2009-01-26 it says that Z50- should not be used either as main diagnosis or secondary diagnosis in Sweden. The recommendations are that the main medical problem (f ex Stroke) is given as main diagnosis and the rehabilitation are shown with the proper KVÅ-codes. That is exactly the way to put the codes for the new rehabilitations DRG´s (550A-560E). But even if the Z50-codes are not to be used we have to decide how NordDRG shall handle Z44.8 - .9.
Suggestion from CPK
DRG 462/462O should be deleted. If the codes Z44.8 - .9 remains during 2010, the dgcat 23M01 (Rehabilitation) should be exchanged to 23M99 (Other factors influencing health status). In-patients with these codes as main diagnosis will then go to DRG 467 (Other factors influencing health status).
In addition Z44.8 - .9 should have the same procedure property as the KVÅ codes GA007 (Adjustment and fitting of other specified prosthesis) and GA009 (Adjustment and fitting of extremity prosthesis) and that is procedure property 40V37. This property will influence only Out-patients and leads to DRG 924O (Fitting of prosthesis or control visit), which is quite appropriate in a medical perspective.
The suggested changes are of minor economic importance since the number of patients with Z44.8 - .9 as main condition is very small. In the Swedish discharge register for year 2007 there were only four in-patients and 61 out-patients.
Expert Network 2009-02-26
The meeting proposed not to delete DRG 462 and 462O. The case will be closed.