Case #285

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

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

Paracentesis and insertion of ventilation tubes

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

Status:AcceptedStart date:2014-02-26
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:MDC03 Old forum status:
Target Grouper:NOR

Description

  • DCSA10 Paracentesis of tympanic membrane
  • DCSA20 Insertion of ventilating tube through tympanic membrane

In NOR these codes have a Norwegian PROCPROP 03O13 ‘Major ENT procedures for children’ and do not have the PROCPROP 03S99 ‘Minor procedure in ear, nose and throat diseases’. For outpatients both properties result in the same DRG 055O and the rules are after each other. For inpatients the 03O13 has no effect on DRG assignment and thus potentially the cases might be assigned to non-surgical DRG’s in the NOR version and to DRG 055X in others. However, since both codes have only OR=2 they will not be assigned to surgical DRG without another OR=1 type intervention. In NOR version even the anesthesia codes do not matter.

If 03S99 is added to the interventions 03O13 becomes redund and should be removed.

Technical change

03S99 is added to DCA10 and DCA20 in NOR version. 03O13 is removed.

DRG change

Minimal change. A few cases may be assigned to DRG 055X instead of conservative DRG’s.

History

#1 Updated by Anonymous over 5 years ago

  • Description updated (diff)

#2 Updated by Anonymous over 5 years ago

  • Priority changed from Normal to Minor

#3 Updated by Martti Virtanen over 5 years ago

  • Subject changed from Paracentesis and insertion of ventilation cx tubes to Paracentesis and insertion of ventilation tubes
  • Description updated (diff)

#4 Updated by Anonymous over 5 years ago

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

Comment Expert Group 2014-03-25

03013 is not removed but otherwise the proposal is accepted by all.

#5 Updated by Martti Virtanen over 5 years ago

2014-03-26 Martti Virtanen

At the expert group discussion Norway pointed out that the property 03O13 should result in assignment to DRG 055P and the other interventions in assigment to DRG 055O. 055P is a DRG only used in Norway for outpatient with only DCA10 or DCA20 interventions. This is important since the clinical practice and the way to deal with this type of patients is different in Norway

Technical change

DCSA10 and DSCA20 (and all linked codes) shall have both 03O13 and 03S99 properties in all versions.
The NOR version logic the rule 103D16300 must have DRG 055O (currently 055P) and it must be followed by rule 103D16301 that can be created as a copy of 103D16300 but DRG must be 055P, OR is changed to ‘P’ (from ‘S’) and Procpro1 is changed to 03O13.

Please note that since DCSA10 and DSCA20 have OR=2 (and not OR=1) the cases with these interventions cannot be assigned according to rule 103D16300 if no other intervention with OR=1 is performed and registered.

DRG change

The Norwegian version will retain DRG 055P for MDC 3 cases with only DCA10 or DCA20. No effect on other versions of NordDRG

#6 Updated by Martti Virtanen over 5 years ago

  • Target Grouper deleted (COMMON, DEN, EST, FIN, ICE, LAT, SWE)

#7 Updated by Martti Virtanen over 4 years ago

2015-01-09 Martti Virtanen
In the list of changes to NordDRG in Norway 19.9.2014 Norway has expressed that in the rule 103D16300 to 055O should be changed to 055P. Thus cases with O3S99 are assinged to DRG 055P as well as cases with 03O13. In the other occurencies of O55O no changes is made. The rules 103D16300 and 103D16301 are the only once resulting in 055P in Norwegian version.
Is this what is wanted by Norway?

#8 Updated by Anonymous over 4 years ago

  • Status changed from Active to Further active

#9 Updated by Martti Virtanen over 3 years ago

  • Status changed from Further active to Accepted

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