Case #278

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

Case #277: Differences of procedure properties between national versions of NordDRG

Properties of additional codes describing use of grafts

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

Status:AcceptedStart date:2014-02-28
Priority:MinorSpent time:-
Assignee:Martti Virtanen
Category:-
Target version:Expert Group 2014
Initiator:Nordic Casemix Centre Target year:2015
Case type: Owner / responsible:Nordic Casemix Centre
MDC:GEN Old forum status:
Target Grouper:COMMON, DEN, EST, FIN, ICE, LAT, NOR, SWE

Description

The codes starting with ZTX in NCSP+ and with ZZ in most national versions have somewhat variable properties. The differences are not motivated, but what is correct, is not always simple to decide.

  • ZTXK00 Graft of nerve
  • ZTXK02 Graft of biosynthetic nerve

Graft of nerve is usually used for neurological problems. The use in orthopedics (08S20 ‘Other musculoskeletal system or connective tissue OR procedure ‘) that is included in SWE version is questionable.

  • ZTXL00 Free graft of amniotic membrane

Amniotic membrane seems to be used somewhat surprisingly only in special eye surgery. Therefore a property for eye MDC (02S03 ‘Extraocular procedure but not procedure of the orbit’) is necessary but a property for orthopedics (08S20) is not needed.

  • ZTXM00 Composite graft

What a composite graft consist of is not totally clear and it is indeed possible that it will be used also in orthopedics. However, only SWE has the property 08S20 for this code.

  • ZTXQ00 Free microvascular graft of skin

To use skin graft in orthopedic surgery is possible, but only SWE accepts that kind of use. I would think that usually there must be more important orthopedic interventions involved and if only skin interventions are performed the principal dx should be skin problem. Therefore I would primarily recommend not accepting 08S20 for this code.

  • ZTXQ10 Free microvascular graft of skin and muscle
  • ZTXQ20 Free microvascular graft of skin, muscle and bone

These codes include muscle and bone and thus it seems logical that they might be used in orthopedics and even in ear, nose and mouth problems. Thus I would add the property 08S20 and 03S01 ‘Major head or neck procedure’ to all versions.

Technical changes

  • 08S20 removed from ZTXK00, ZTXK02, ZTXL00 and ZTXQ00 (and linked codes) in all versions (SWE)
  • 08S20 added for ZTXM00, ZTXQ10 and ZTXQ20 (and linked codes) in all versions
  • 02S03 added for ZTXL00 (and linked codes) in all versions
  • 03S01 added for ZTXQ10 and ZTXQ20 (and linked codes) in all versions

DRG changes

Hardly any since the codes are allowed to be used only as an additional code in an intervention (all have 00S99 ‘Unspecified or impossible procedure’)

History

#1 Updated by Anonymous about 5 years ago

  • Description updated (diff)
  • Target year 2015 added

#2 Updated by Anonymous about 5 years ago

  • Priority changed from Normal to Minor

#3 Updated by Martti Virtanen about 5 years ago

2014-03-17 Martti Virtanen
This is the matter as in case #260.
The matter has been discussed in case #235 and #211

#4 Updated by Anonymous about 5 years ago

Comment Expert Group 2014-03-25

Decided in the other related cases. See case #260.
Proposal accepted.

#5 Updated by Martti Virtanen about 5 years ago

2014-03-27 Martti Virtanen

ZTXQ10 and ZTXQ20 together with ZTXQ30 is dealth with in Case #293 ‘ZZQ20 and 03S01’

Technical change

08S20 is added to ZTXK00, ZTXK02, ZTXL00 and ZTXQ00 (and linked codes) in all versions
08S20 added for ZTXM00, ZTXQ10 and ZTXQ20 (and linked codes) in all versions
02S03 added for ZTXL00 (and linked codes) in all versions
03S01 added for ZTXQ10 and ZTXQ20 (and linked codes) in all versions

DRG change

Hardly any since the codes are allowed to be used only as an additional code in an intervention (all have 00S99 ‘Unspecified or impossible procedure’)

#6 Updated by Anonymous about 5 years ago

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

#7 Updated by Martti Virtanen almost 5 years ago

2014-05-05 Martti Virtanen
The last line of technical changes was missing
Í have added it now.

#8 Updated by Anonymous about 4 years ago

  • Status changed from Active to Accepted

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