Case #273

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

Hard coding in the grouper of code complicating oneself

Added by Anonymous about 5 years ago. Updated about 4 years ago.

Status:AcceptedStart date:2014-02-27
Priority:MinorSpent time:-
Assignee:Mona Heurgren
Category:-
Target version:Expert Group 2014
Initiator:Sweden Target year:2015
Case type: Owner / responsible:Nordic Casemix Centre
MDC: Old forum status:
Target Grouper:SWE

Description

National ID: CPK ID 551
Initiated: 2014-02-27
Responsible at National organization: Mona Heurgren, Mats Fernström, Ralph Dahlgren

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Problem

CPK at the National Board of Health and Welfare in Sweden suggest that there should be a change in the hard coding of the grouper.
The suggestion concerns the fact that there are a rule that says that one specific ICD-10 code should not be able to complicate itself.
The example are that ICD-10 code E10.9 Diabetes mellitus typ 1 utan (uppgift om) komplikationer (In English: Type 1 diabetes mellitus without (indications of) complications) given as main diagnos and secondary diagnos should not complicate itself.
So in case of wrong coding, which it is, to use the same code twice the grouper handles it automatically in the future.

Analysis

This needs to be discussed at the Expert meeting. Both pro and con.
If decided as Sweden suggests it also has to be written down to clarify how the grouper works.
This would increase the transparency of the system and also decrease the file “Compl. Exl” with the number of ICD-10 codes in use.

Suggestion

CPK at the National Board of Health and Welfare, Sweden - 2014-02-27

The suggestion is to have hard coding change done in the grouper.
No technical changes are made since it concerns hard coding of the grouper.

Decided changes

Discussed and decided at the Expert meeting 2014-03-24-25 and if accepted to be introduced in the definitions tables for 2015.

DRG change

Here there will not be any changes compared to how it should be at the moment.

Technical change

Hard coding in the groupers have to be done in all the groupers and might look a little different depending on how it is programmed now.

Introduction

NordDRG [2015] [All]

History

#1 Updated by Anonymous about 5 years ago

  • Parent task set to #11

#2 Updated by Anonymous about 5 years ago

  • Description updated (diff)
  • Target version set to Expert Group 2014

#3 Updated by Martti Virtanen about 5 years ago

  • Target Grouper deleted (COMMON, DEN, EST, FIN, ICE, LAT, NOR)

2014-03-17 Martti Virtanen
The current model that we have imitated from the US system, is that the complicating dx's form complication categories that cannot complicate as principal dx the dx's on the exclusion list for that complication category. The main idea is that registrating the same dx twice cannot result in assignment to CC-categories.

The example E1090 belongs to complication category 10C02. All diabetes dx (E10-E11) belong to this category and are also on the exclusion list of that category. Thus a diabetes dx as a secondary dx is potentially complicating factor but these dx's cannot convert a case with principal dx of diabetes to a CC/MCC DRG.

Taking in account the dagger asterisk coding possibility obviously makes tha matter even more complicated.

We have a quite simple principle which turns to a very complex process. Any proposal to create a more simple and more transparent system is welcome. The main concern that repeating a diagnosis may not be allowed to result in CC/MCC assignment is in principle taken care off. If such situation turns out to be possible, we need to consider the exclusions at issue.

#4 Updated by Anonymous about 5 years ago

Comment Expert Group 2014-03-25

Discussed and decided in Case #233.

#5 Updated by Anonymous about 4 years ago

  • Status changed from Active to Accepted

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