Task #10: Delivery of major update proposals for NordDRG 2015
Z094D groups different from Z09.4 + S52.50
|Target version:||Expert Group 2014|
|Case type:||Owner / responsible:||Nordic Casemix Centre|
|MDC:||MDC08||Old forum status:|
|Target Grouper:||COMMON, DEN, EST, FIN, ICE, LAT, NOR, SWE|
National ID: 435
Responsible at National organization: Ralph Dahlgren/Susann Berggren
During the RDK –days (Rikssektionen för Diagnos-Kodning) a discussion of coding came up. The issue concerned control after fracture without complications. This can be coded in Sweden in two different ways. Either with Z09.4D as the only code or Z09.4 + S52.50. The problem is that the two different way of coding groups to two different DRG´s. From KLT (The Swedish Centre of Klassification) side it is correct to code in either way. The DRG system definitely must support correct coding.
Excel File shows that all codes Z094A-K lacks DGPROP 08X99. If these codes have DGPROP 08X99 added the grouping will be correct.
NPK, Sweden 2013-10-22
Sweden wants all Z094 codes to get the grouping property DGPROP 08X99. The codes that are involved are: Z094, Z094A, Z094B, Z094C, Z094D, Z094E, Z094F, Z094G, Z094H, Z094J, Z094K, Z094X.
See Excel File .
NPK, Sweden 2013-10-22
Sweden has decided that these changes should be introduced in the Swedish NordDRG for 2015.
The following codes should have DGPROP 08X99 added:
Z094 Kontrollundersökning efter frakturbehandling DGPROP 08X99,
Z094A Kontroll efter fraktur i halsregionen DGPROP 08X99,
Z094B Kontroll efter fraktur på axel/överarm DGPROP 08X99,
Z094C Kontroll efter fraktur på armbåge/underarm DGPROP 08X99,
Z094D Kontroll efter fraktur på handled/hand DGPROP 08X99,
Z094E Kontroll efter fraktur i bäckenregionen DGPROP 08X99,
Z094F Kontroll efter fraktur på höft/lår DGPROP 08X99,
Z094G Kontroll efter fraktur på knä/underben DGPROP 08X99,
Z094H Kontroll efter fraktur på fotled/fot DGPROP 08X99,
Z094J Kontroll efter fraktur i torakalregionen DGPROP 08X99,
Z094K Kontroll efter fraktur i ländregionen DGPROP 08X99,
Z094X Kontroll efter fraktur med icke specificerad lokalisation DGPROP 08X99
#2 Updated by Martti Virtanen about 5 years ago
20014-03-19 Martti Virtanen
The xxX99 properties were created as a results of case Case 2007-MDC23-01 Follow-up examination (Z08-Z09).
From that case the text from CPK starts: ‘According to Swedish coding rules, follow-up examination shall be registered with the Z-code (Z08-Z09) as the principal diagnosis and the underlying condition that is controlled shall be registered as the secondary diagnosis.’
The discussed effect was also commented in this case: ‘If no disease is recorded the cases are assigned to DRG 467/923O (inpatient/short stay)’
Thus the instructions have now been changed and it is allowed to use the codes of this group without the additional code for the underlying condition at issue. This is understandable since the added subcodes already quite exactly indicate the problem. The dx at issue are following:
Z094 Follow-up examination after treatment of fracture
Z094A Follow-up examination after treatment of fracture of neck
Z094B Follow-up examination after treatment of fracture of shoulder or upper arm
Z094C Follow-up examination after treatment of fracture of elbow or lower arm
Z094D Follow-up examination after treatment of fracture of wrist or hand
Z094E Follow-up examination after treatment of fracture of pelvis
Z094F Follow-up examination after treatment of fracture of hip or femur
Z094G Follow-up examination after treatment of fracture of knee or leg
Z094H Follow-up examination after treatment of fracture of ankle or foot
Z094J Follow-up examination after treatment of fracture of thoracal region
Z094K Follow-up examination after treatment of fracture of lumbar region
Z094X Follow-up examination after treatment of fracture
Since the property 08X99 is an autogenerated property to all codes with MDC 08, it is problematic to use otherwise. The practical effect would be, that these dx would be regarded as MDC 08 dx. The the simple solution is to give the diagnosis a MDC 08 diagnosis category, most naturally 08M99 ‘Other musculoskeletal system and connective tissue diagnoses’. Another option is to use the localizing diagnosis categories when applicable