Case #405

Removal of genital virus warts

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

Status:AcceptedStart date:2015-02-26
Priority:MinorSpent time:-
Assignee:Kristin Dahlen
Category:-
Target version:Expert Group 2015
Initiator:Norway Target year:2016
Case type:Minor Owner / responsible:National organisations
MDC:MDC13 Old forum status:
Target Grouper:NOR

Description

National ID: HD-0096
Initiated: 2015-02-25
Initiator: Norwegian Directorate of Health
Responsible at National organization: Kristin Dahlen
Sent to NordDRG Forum: 2015-02-25
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Problem
Removal of virus warts from tissue on mens genitals, KGSD20/KGD20 'Destruction of lesion of skin of penis' is treated technically different in the DRG logic than the corresponding treatment done on womens genitals. In Norway there is a special code for this intervention LFB30 'Destruksjon av lesjon i hud i vulva eller perineum' that is linked in NCSP+ to LFSB20/LFB20 'Destruction of lesion of vulva or perineum'.

According to information given by Norwegian doctors the treatment is similar when it comes to resource use.

The procedures do not require an operating room, and is done with brief anesthesia with manual ventilation of the patient.

Analysis
Norwegian directorate of health

No economical analysis available.

2015 DRG-logic:

Suggestion
Norwegian directorate of health – 2015-02-25

We suggest that procedure code LFB30 is given OR=2 property.
LFB30 is also given PROCPR 13O04 Other minor gynecologic outpatient procedure. This will lead to DRG 813T Other outpatient gynecological procedure in the Norwegian version.

HD-0096.jpg (49.7 KB) Anonymous, 2015-02-26 15:44

13S04.jpg (204 KB) Martti Virtanen, 2015-03-05 16:39

405RalphDahlgrenComment.jpg (18.6 KB) Anonymous, 2015-03-12 11:52

Case #405 Technical changes.xlsx (12.8 KB) Martti Virtanen, 2015-03-17 12:33

History

#1 Updated by Martti Virtanen almost 5 years ago

2015-03-03 Martti Virtanen
Norway: has two codes for this area.
LFB20 'Destruksjon av lesjon i vulva eller perineum'
LFB30 'Destruksjon av lesjon i hud i vulva eller perineum'

Semantically these codes do not exclude each other, LFB30 is included int LFB20. In NCSP+ they are linked together to LFSB20.

It would be possible to create a new code for LFB30 in NCSP+ although because of the semantic problem the definition of this code would be problematic. With the new NCSP+ code the practical problem could be solved without disturbing NordDRG in other countries.

There is a further problem. Because of the semantic problem, it is obvious that it is never wrong to use LFB20 instead of LFB30. Why would anybody use LFB30 when one gets better reimbursement with LFB20??

Another question to all countries is, are the cases with LFB20 really as resource intensive as the cases with other interventions with PROCPRO 13S04?

#2 Updated by Ralph Dahlgren almost 5 years ago

Sweden has not LFB30.
Our cost data shows the following:

We therefore can not support that LFB20 should get a changed in group-ing characteristics as these patients fits quite well where they are now. Sweden has no DRG that corresponds to DRG 813T.

#3 Updated by Anonymous almost 5 years ago

#4 Updated by Martti Virtanen almost 5 years ago

2013-03-13 Expert group/MV
The expert group discussed the problems of the Norwegian coding. The codes are not mutually exclusive.
It was decided that the LFB30 'Destruksjon av lesjon i hud i vulva eller perineum' needs a new code in NCSP+ and that the new code that will have properties OR=2 and PROCPR 13O04 and no other properties.

#5 Updated by Anonymous almost 4 years ago

  • Target version changed from Minor-Proposals-for-2016 to Expert Group 2015

#6 Updated by Martti Virtanen almost 4 years ago

  • Status changed from Active to Accepted

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