Case #251

Task #11: Delivery of minor update proposals for NordDRG 2015

Chronic laryngitis

Added by Anonymous about 5 years ago. Updated over 2 years ago.

Status:AcceptedStart date:2014-02-13
Priority:MinorSpent time:-
Assignee:Mats Fernström
Category:-
Target version:Expert Group 2014
Initiator:Sweden Target year:2015
Case type: Owner / responsible:Nordic Casemix Centre
MDC: Old forum status:
Target Grouper:COMMON, DEN, EST, FIN, ICE, LAT, NOR, SWE

Description

National ID: NPK ID 535
Initiated: 2013-11-13
Initiator: NPK, Sweden

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Problem

The Swedish National Board of Health and Welfare (SOS) makes own definition tables parallel to the process at the Nordic Casemix Centre (NCC) and the current problem was discovered during routine comparison between SWE2014CC-SOS-PR02 (SOS version) and SWE2014PR0F (NCC version) in the autumn 2013.

The J37 diagnosis codes (Chronic laryngitis and laryngotracheitis) have had DGCAT 03M05 for at least 10 years in the Swedish versions of NordDRG. Late in the updating process for version 2014 Martti wanted to change DGCAT to 03M08 for the J370 codes (including the Swedish subcodes) with the motivation that it was an “adjustment between the Nordic versions, must be the same in all versions”. We did not accept the change in the SOS version.

We agree that the codes should have the same DGCAT in all versions but it has never been discussed weather 03M05 or 03M08 is the best property.

Analysis

DGCAT 03M05 leads to DRG C35 (DRG 70 in Common) with the text “Otitis media and upper respiratory infections” and DGCAT 03M08 leads to DRG C48/C49 (DRG 73/74 in Common) with the text “Other ear, nose, mouth & throat diagnoses”. In a medical descriptive perspective we think that DRG C35/70 is a better alternative, especially since DRG C48/C49/73/74 are heterogeneous rest groups.
We have done an economic analysis (see table below).

According to this the mean cost for the J37 cases is somewhat closer to the mean cost for all DRG C35E than for the mean costs for DRG C48/C49.
Thus we think that DRG C35/70 is a better alternative for the J37 cases, also in an economic perspective and therefore DGCAT 03M05 is better than 03M08 for the J370 codes.

Suggestion

NPK, Sweden – 2014-01-29

Based on the analysis above we suggest that the DGCAT value is changed from 03M08 to 03M05 in all versions of NordDRG. See Suggestion NPK ID 535.

2014-CPK-ID-535.jpg (18.3 KB) Anonymous, 2014-02-18 12:16

Suggestion CPK ID 535.xls (35.5 KB) Anonymous, 2014-02-18 12:19

Case #251 Technical changes - J381B adn J381D.xlsx (11.2 KB) Martti Virtanen, 2015-03-26 21:18

History

#1 Updated by Anonymous about 5 years ago

  • Parent task set to #11

#2 Updated by Martti Virtanen about 5 years ago

2014-03-13 Martti Virtanen
I agree with Swedish reasoning. Do the other countries have any comparable results?
This is the same problem as in case #123 and #298 which can be omitted.

#3 Updated by Martti Virtanen about 5 years ago

  • Description updated (diff)

#4 Updated by Anonymous almost 5 years ago

Comment Expert Group 2014-03-24

Change accepted according to swedish proposal.

#5 Updated by Martti Virtanen almost 5 years ago

2014-03-27 Martti Virtanen

Technical change

J370 Chronic laryngitis and all linked codes shall have DGCAT 03M05

DRG change

The cases will be assigned to DRG 070 (C35) instead of DRG 73-74 (C48-C49)

#6 Updated by Anonymous almost 5 years ago

  • Target Grouper COMMON, DEN, EST, FIN, ICE, LAT, NOR, SWE added

#7 Updated by Martti Virtanen over 4 years ago

2014-09-11 Martti Virtanen Nordic Casemix Centre
A further additional detail to this discussion:

The codes
J381B 'Reinke's edema'
J381D 'Oedema of vocal cords'
are linked to J3700 'Chronic laryngitis' and not to J3810 'Polyp of vocal cord and larynx' in ICD+. .
The linkage is reasonable since J381D does indicate any polyp and J381B is a condition with chonic inflammatory changes resembling polyps. The question is, are inflammatory polyps, polyps or chronic inflammation.
J3810 belongs to diangosis catogery 03M09 but due to this decission J381B and J381D will be moved to diagnosis category 03M05.

#8 Updated by Anonymous about 4 years ago

  • Status changed from Active to Further active

#9 Updated by Ralph Dahlgren about 4 years ago

The ICD-codes J381B Reinkeödem ('Reinke's edema' ) and J381D Randstående stämbandsödem ('Oedema of vocal cords' ) are not infections.
This means that the codes should not have the DGCAT 03M05 Otitis media and upper respiratory infection. Instead it should have the DGCAT 03M08 Other ear, nose, mouth and throat diagnoses. This means that the code has to be linked to another ICD+ code than J3700

#10 Updated by Martti Virtanen almost 4 years ago

2015-03-13 Expert group/MV
It is obvious that mapping has to be changed in a way that will solve the problem.

#11 Updated by Martti Virtanen almost 4 years ago

2015-03-26 Martti Virtanen
This problem basically illustrates the fact that chronic laryngitis is actually not an infectious disease but an inflammation.
However to solve the problem I propose that we link J381B and J381D to J38700

#12 Updated by Anonymous over 2 years ago

  • Status changed from Further active to Accepted

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