Case #221

Case 2007-MDC02-01 Photodynamic treatment of macula degeneration

Added by Anonymous about 6 years ago.

Status:RejectedStart date:2014-01-30
Priority:NormalSpent time:-
Assignee:-
Category:-
Target version:Expert Group 2008
Initiator:Sweden Target year:
Case type:Major Owner / responsible:
MDC:MDC02 Old forum status:CLOSITEM - Closed item
Target Grouper:

Description

Last updated: 2008-04-07
Status: CLOSITEM - Closed item
Initiated - 2007-02-15
By: Mats Fernström, CPK, Sweden
Expert Network 2007-03-28 - Postpone recommended
Steering Group 2007-04-11 - Recommendation accepted
Expert Network 2008-03-06 - Proposal rejected
Steering Group 2008-03-31 - Recommendation accepted

BACKGROUND:

CPK ID 217

Photodynamic treatment of macula degeneration (Swedish code DC001) is a rather expensive outpatient procedure (approx. 15 000 SEK). The cost is approximately the same as the mean cost of DRG 036O and therefore I suggest that DC001 and other Nordic codes with the same meaning are grouped to DRG 036O. This is achieved by changing the OR property from 2 to 1 (procedure property 02S02 is already present).

COMMENTS:

Expert Network 2007-03-28

The meeting proposed to postponing the case for short therapy in the workingroup for MDC 2

CPK, Sweden 2008-02-08

There is no cost data to verify the real costs of procedure DC001. Therefore it must be a medical decision if the code should have OR property 1 or 2. A new expensive drug (Lucentis) is now on the market, these costs are not included yet in the DRG-weights.

Martti Virtanen 2008-02-19

No other country has the code for photodynamic therapy of eye. But all, except Denmark and Estonia but including Sweden, have code for ‘Use of photodynamic technique’ (ZXXC80, ZXC15 in NCSP). This can be combined to CKSC19 ‘Photocoagulation of retina’ (CKC12) and that would mean exactly the same as DC001.

Expert Network 2008-03-06

The meeting decided to reject the proposal. A new case with new information. The case will be closed.

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