Case #422

The ‘tooth and mouth diseases’ need to be defined for DRG DRG 186O/C55O in NordDRG SWE

Added by Martti Virtanen over 5 years ago. Updated over 4 years ago.

Status:AcceptedStart date:2015-03-11
Priority:Error correctionSpent time:-
Assignee:-
Category:-
Target version:Expert Group 2015
Initiator:Nordic Casemix Centre Target year:2016
Case type:Error correction Owner / responsible:
MDC:MDC03 Old forum status:
Target Grouper:SWE

Description

Problem
This case is a result of the NDMS checkup by listing all rules that do not have any test cases in our test database. In this case there is an obvious error.

Error in ord 200D16920 (DRG 186O/C55O ’ Läkarbesök vid tand- & munhålesjukdomar utom tandextrakt & restaurering’). It catches all potential cases to DRG 776V/C99O ‘Other medical contact for ear, nose and mouth problems, short therapy‘ and the content does not correspond to the description
The rule for DRG 186O/C55O only differs by having ‘N’ on the variable OR from to rule for DRG DRG 776V/C99O. Both are non-surgical groups because surgical groups are assigned earlier in the table. Therefore the content is identical and DRG 776V/C99O becomes impossible.

Analysis
Economic analysis is not possible because there are currently no cases in DRG 776V/C99O.
The content of DRG 186O/C55O does not correspond to the title and there is obviously an error in the rule.
Suggestion
A correction to the rule of DRG DRG 186O/C55O. The ‘tooth and mouth diseases’ need to be defined
Technical change
Not available
DRG change
The content of DRG 186O/C55O will get corrected

776V.jpg (43.8 KB) Martti Virtanen, 2015-03-12 00:11

776V_rule.jpg (313 KB) Martti Virtanen, 2015-03-12 00:12

Decisions C600 (#422).xlsx (15.1 KB) Anonymous, 2015-06-17 14:41

History

#1 Updated by Martti Virtanen over 5 years ago

  • Description updated (diff)

#2 Updated by Martti Virtanen over 5 years ago

  • Priority changed from Minor to Error correction

2015-03-13 Expert group/Martti Virtanen
Sweden will check the case before 08/2015

#3 Updated by Anonymous over 5 years ago

Mats Frenström, NPK, Sweden 2015-06-16:
Martti is right. The rules for DRG 186O/C55O and DRG 776V/C99O are almost identical and both groups are MDC 03 rest groups for outpatient visits. The text to DRG 186O/C55O was fetched from the inpatient logic and is misleading.
We want to solve the problem by deletion of DRG 186O/C55O. We want this to be done in the production version for 2016.
Detailed technical changes are described in Decisions to Forum C600 (#422).xlsx.

#4 Updated by Anonymous over 5 years ago

Matts Fenströms excel-file added to forum.

#5 Updated by Anonymous over 4 years ago

  • Target version changed from Target version 2016 to Expert Group 2015

#6 Updated by Martti Virtanen over 4 years ago

  • Status changed from Active to Accepted

2016-03-15 Expert group (MV)
The case was closed without further discussion

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