Case #261

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

Merging DRGs 580J and 580G (MDC3 (Diseases and disorders of ear, nose, mouth and throat)

Added by Anonymous over 5 years ago. Updated about 3 years ago.

Status:AcceptedStart date:2014-02-13
Priority:MinorSpent time:-
Assignee:Martti Virtanen
Category:-
Target version:Expert Group 2014
Initiator:Finland Target year:2015
Case type: Owner / responsible:Nordic Casemix Centre
MDC:MDC03 Old forum status:
Target Grouper:FIN

Description

CPK ID: 2014/01
Initiator: National DRG Centre in Finland / Kristiina Kahur, Minna-Liisa Sjöblom
Responsible at NPK: Kristiina Kahur, Minna-Liisa Sjöblom

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Problem

Finnish national DRG-center got a request from one hospital district regarding some problem in dental care DRGs 580J ‘Major mouth radiology with anesthesia’ and 580G ‘Mouth care with anesthesia’. The difference in grouping logic depends on the presence of radiology code.

The 580H ‘Mouth and jaw surgery with with significant radiology or anesthesia’ was not questioned. These DRG’s are part of the Finnish national NordDRG model and not included in the common NordDRG, nor in any other version of NordDRG. A block of dental care DRGs were introduced in Finnish national version in 2013.

The background information is available in Case 2012-MDC03-01 Dental care DRG's for NordDRG [[http://documents.norddrg.net/issues/115]]).

Back then the data of 2010 was used for developing the new grouping logic for dental care and the analysis showed that the cases with radiology are more expensive and need a separate DRG (580J). However, the most recent data doesn’t support that anymore. In addition, the number of cases in this DRG is relatively low.

Analysis

For analysis the data of 5 university hospitals of Finland from year 2012 was used. For grouping Finnish 2014 Full version was used. From analyses the cases less than 300€ were excluded.

Suggestion

We suggest to merge DRGs 580J and 580G. The DRG and its name remain as they have been: 580G ‘Mouth care with anesthesia’.

2014-CPK-ID-2014-01.jpg (39.6 KB) Anonymous, 2014-02-19 14:41

History

#1 Updated by Anonymous over 5 years ago

  • Parent task set to #10

#2 Updated by Martti Virtanen over 5 years ago

  • Priority changed from Major to Minor

#3 Updated by Anonymous over 5 years ago

  • Parent task changed from #10 to #11

Comment Expert Group 2014-03-24

Relevant only for Finland and as information for other countries that this will be done in Finnish version.

#4 Updated by Martti Virtanen over 5 years ago

2014-03-27 Martti Virtanen

Technical change

The rules for DRG 580J ORD 103D010005 and 191D000005 are inactivated

DRG change

Cases currently assigned to DRG 580J will be assigned to DRG 580G

#5 Updated by Martti Virtanen over 5 years ago

2014-06-28 Martti Virtanen
I have missed the addtional rule 191D000005 for DRG 580J. There are no cases in the Finnish data for 2013 for this rule i.e. it is a very theoretical rule. If a case with 03P01 and mouth radiology in anaesthesia short therapy case would appear without this extra rule they would be assigned to MDC 8 or MDC 19 DRG's. This is almost impossible and probably missregistration. Therefore The rule 191D000005 shall simply be removed. (It has additionally an error, anaesthsia should be 03X10 not 00X10).
I have corrected the technical change accordingly.
The correction will be made to next version of NordDRG FIN

#6 Updated by Anonymous almost 5 years ago

  • Status changed from Active to Further active

#7 Updated by Anonymous about 3 years ago

  • Status changed from Further active to Accepted

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