Case 2009-GEN-05 Hierarchy in transplantation
|Priority:||Error correction||Spent time:||-|
|Target version:||Expert Group 2009|
|MDC:||GEN||Owner / responsible:|
|Target Grouper:||COMMON||Old forum status:||CLOSITEM - Closed item|
Last updated: 2010-04-09
Status: CLOSITEM - Closed item
Error corrected by Nordic Centre
By: Eva Nilsson, VGR/CPK, Sweden
Expert Network 2010-03-12 - Correction recommended
Board 2010-04-09 - Recommendation accepted
CPK ID 301
A patient that goes through a heart transplant (FQA00) and a kidney transplant (KAS10) at the same time will go to DRG 302 (Weight 8,358). If the kidney transplant is not recorded the patient will go to DRG 103 (Weight 22,1573).
According to the hierarchy of the NordDRG logic the kidney transplant (400D3003) comes before heart transplant (400D3004).
This is obviously wrong. The order should follow the weights.
Change the hierarchy order of heart transplant to come before pancreas transplant. Such a change can be done without any further investigation. We think that this is an error that can be corrected by the Nordic Casemix Centre in the 2010 version without discussion in the expert network (but it should be documented in the NordDRG Forum).
Martti Virtanen 2009-07-22
I agree with Mats. The data from Finland supports the Swedish data although in the somewhat old data there were no pancreas transplants. In the Finnish data heart transplant was somewhat more expensive than lung transplant patients. Since transplantion of heart and lung has its own code that is included in heart transplants, this is not a problem any way.
Nordic Centre, Martti Virtanen 2009-10-07
DRG 103 is moved between DRG 495 and DRG 191A.
It is also questionable whether stem cell transplantations are more expensive than lung and heart transplantations. However, they probably never are done simultaneously.
Expert Network 2010-03-12
The meeting recommended accepting the correction.
Rule 400D3004 ‘Heart transplant’ is moved before rule 400D3002.
Cases with simultaneous heart and other organ than lung transplant are assigned to DRG 103.