Case #406

Chronic obstructive pulmonary disease (COPD)

Added by Anonymous over 6 years ago. Updated over 5 years ago.

Status:AcceptedStart date:2015-02-26
Priority:MinorSpent time:-
Assignee:Kristin Dahlen
Target version:Expert Group 2015
Initiator:Norway Target year:2016
MDC:MDC04 Owner / responsible:National organisations
Target Grouper:NOR Old forum status:


National ID: HD-0101
Initiated: 2015-02-25
Initiator: Norwegian Directorate of Health
Responsible at National organization: Kristin Dahlen
Sent to NordDRG Forum: 2015-02-25
This case is related with the Case 2007-MDC04-01 Respiratory failure on old forum that is not yet on the new NordDRG Forum. (Added as forum Case #412)

In Norway we observe some problems with coding of patients with chronic obstructive pulmonary disease with acute infection in the lower respiratory tract.

It is suggested to move J4400 'Chronic obstructive pulmonary disease with acute lower respiratory infection' to the same DRG as J2200 'Unspecified acute lower respiratory infection' and J1590 'Bacterial pneumonia, unspecified' - DRG 089-090/047A-C-E 'Simple pneumonia & pleurisy' (children/adults - w cc/ without cc).

Norwegian directorate of health

No economic analysis available.

Length of stay analyses based on preliminary data from all hospitals in Norway 2014.

DRG 88, 89 and 90 by mean conditions J440, J22 and J159.

Norwegian directorate of health – 2015-02-25

We suggest that J44.0 is moved to DGCAT 04M08 'Simple pneumonia and pleurisy' from
DGCAT 04M07 'Chronic obstructive pulmonary disease'.

If these changes is supported, we must consider the names of both DRG 88 ad DRG 89/90.

HD-0101-88.jpg (21.9 KB) Anonymous, 2015-02-26 15:50

HD-0101-89.jpg (22 KB) Anonymous, 2015-02-26 15:51

HD-0101-90.jpg (22 KB) Anonymous, 2015-02-26 15:52

HD-0101-J159.jpg (27.5 KB) Anonymous, 2015-02-26 15:53

HD-0101-J22.jpg (23.8 KB) Anonymous, 2015-02-26 15:55

HD-0101-J440.jpg (24 KB) Anonymous, 2015-02-26 15:56

Comment to Forum#406 (21.5 KB) Anonymous, 2016-01-27 12:13

Technical changes #406.xlsx (12.1 KB) Mats Fernström, 2016-03-16 18:14

Technical changes case #406.xls (42.5 KB) Martti Virtanen, 2016-04-14 10:49


#1 Updated by Martti Virtanen over 6 years ago

  • Description updated (diff)

2015-03-05 Martti Virtanen
The problem in Norway is probably the same or closely related to the problem that has been solved in ohter versions by 'Case 2007-MDC04-01'. This cases has not been implemented in Norway.

I suspect that the other countries cannot agree on this case without proper economic analysis. Also the implementation of the 'Case 2007-MDC04-01' should be considedred in Norway

#2 Updated by Anonymous over 6 years ago

  • Description updated (diff)

#3 Updated by Ralph Dahlgren over 6 years ago

Due to the short period of time we could only do a very shallow cost control.
This showed that the cost difference was not considerably high. But when it came to ICD-code J15.9 was the number very few (5 patients) and they were grouped to DRG Z60 (Former DRG 477).
We would have to look deeper into this issue to be able to accept this suggestion. There might be other codes close to these codes that also should be changed.

#4 Updated by Martti Virtanen over 6 years ago

  • Status changed from Active to Further active
  • MDC MDC04 added

2015-03-13 Expert group/MV
The case is postponed for economical analysis.

#5 Updated by Anonymous over 5 years ago

26.1.2016 Veronika Stemme
After economical analysis Sweden support this suggestion, Forum ID#406, please see the attached file: Comment to Forum #406.

#6 Updated by Anonymous over 5 years ago

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

#7 Updated by Mats Fernström over 5 years ago

Mats Fernström, NPK, Sweden, 2016-03-16
This case was discussed at the Expert Network meeting 2016-03-14 – 15. Swedish cost data support the Norwegian proposal and it was decided to be implemented. The file Technical changes #406.xlsx is attached.

#8 Updated by Kristiina Kahur over 5 years ago

Finnish National DRG-Centre 2016-03-17

The result of economic analysis based on Finnish five university hospitals data (2014) was similar to Swedish one.
It supports the Norwegian proposal to change of DGCAT of dx code J440 and use the DGCAT 04M08 'Simple pneumonia and pleurisy' instead of 04M07 'Chronic obstructive pulmonary disease'.

#9 Updated by Martti Virtanen over 5 years ago

2016-04-14 Nordcase (MV)
Both SWE and FIN have confirmed that the proposal has excepted effects and therefore the proposal is proposed to be accepted.
The Technical change document indicates that all versions are affected.

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