Case #288

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

Transvenous biventricular pacemaker with electrodes

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

Status:AcceptedStart date:2014-02-27
Priority:MinorSpent time:-
Assignee:Ralph Dahlgren
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 481
Initiated: 2014-02-18

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Problem

The NordDRG users have informed the Swedish National Board of Health and Welfare that there are big differences between the procedures in DRG E26/116.
The codes involved are:

  • FPE00 Inläggande av transvenös pacemaker med ventrikelelektrod
  • FPE10 Inläggande av transvenös pacemaker med förmakselektrod
  • FPE20 Inläggande av transvenös pacemaker med förmaks- och ventrikelelektrod och
  • FPE26 Inläggande av transvenös pacemaker med biventrikulära elektroder

The last procedure, FPE26 is the most advanced surgery. This involves a Heartfailure Pacemacer, CRT. The cost is higher than for a regular pacemaker (50 000 SEK compared to ~15 000 SEK) but most of all, the surgery time is three times compared to the other procedures. The late complications are also more frequent. The number CRT that is done in Sweden are around 1 000, and increasing because the guidelines for heart treatments includes the CRT treatment. The current grouping doesn´t take this into account when grouping

Analysis

Suggestion

The Swedish National Board of Health and Welfare 2014-02-18

The suggestion is that the cases with FPE26 should be grouped to DRG E26A every time the procedure is performed, even though no MCC factor is present.

Decided changes

The Swedish National Board of Health and Welfare 2014-02-18

If possible done for Sweden in 2015

DRG change

Cases will move from E26E Insättning/byte av pacemaker U and E26C Insättning/byte av pacemaker K to DRG E26A Insättning/byte av pacemaker M

Technical change

The suggestion is that there is an additional line in DRGlogic that leads to DRG E26A. This row is a copy of the row that leads to DRG 26A. The new row have to get a new PROCPRO, PFE26 should have PROCPRO 05S43 added to that new row. FPE26 keeps the old PROCPRO 05S41 to be able to be used in daycare but get the new 05S43 added. The new PROCPRO: 05S43 Implantation of biventricular pacemaker.

For technical changes see Excel-file CPK ID 481 Decision to Forum.

Introduction

NordDRG [SWE] [2015]

2014-CPK-ID-481.jpg (45 KB) Anonymous, 2014-03-14 12:41

Decision CPK ID 481.xls (64.5 KB) Anonymous, 2014-03-14 12:43

History

#1 Updated by Martti Virtanen over 5 years ago

2014-03-17 Martti Virtanen
I see no problem with the proposed model. This has no effect on other countries since no CC-level group exists for the DRG 116 at issue

#2 Updated by Anonymous over 5 years ago

Comment Expert Group 2014-03-25

Proposal is accepted. Will remain as is other countries, change only in Sweden.

#3 Updated by Martti Virtanen over 5 years ago

2014-03-26 Martti Virtanen

Technical change

A new procedure property 05S43 ‘Implantation of biventricular pacemaker’ is added.
The new PROCPRO is given to FPSE25 (FPE26 in SWE)
Note FPSE25 retains the PROCPRO 05S41.
In the SWE logic table a new row is added immediately after current row 405D120140. The new row is a copy of 405D120140 but Procpro1 is changed to 05S43 and Compl value is removed (becomes empty).

DRG change

In SWE version biventrilular pacemaker treatment (FPSE25/FPE26) results in MCC even in the absence of complicating dx’s.
Note FPSE25 is only used in Sweden (FPE26) and thus this groupin will not affect any other version.

#4 Updated by Anonymous over 4 years ago

  • Status changed from Active to Accepted

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