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)
|Target version:||Expert Group 2014|
|Case type:||Owner / responsible:||Nordic Casemix Centre|
|MDC:||MDC03||Old forum status:|
CPK ID: 2014/01
Initiator: National DRG Centre in Finland / Kristiina Kahur, Minna-Liisa Sjöblom
Responsible at NPK: Kristiina Kahur, Minna-Liisa Sjöblom
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 [[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.
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.
We suggest to merge DRGs 580J and 580G. The DRG and its name remain as they have been: 580G ‘Mouth care with anesthesia’.
#5 Updated by Martti Virtanen about 6 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