Case #429

Unusual combination of diagnosis and intervention assigned to DRG 470

Added by Martti Virtanen over 4 years ago. Updated over 3 years ago.

Status:AcceptedStart date:2015-04-08
Priority:Error correctionSpent time:-
Assignee:-
Category:-
Target version:Expert Group 2016
Initiator:Estonia Target year:2014, 2015, 2016
Case type: Owner / responsible:
MDC:GEN Old forum status:
Target Grouper:COMMON, EST, LAT

Description

Initiated: 2015-04-08
Initiator: Kristiina Kahur: Estonian Heath Insurance Fund
Responsible at National organization: Kristiina Kahur : EHIF
Sent to NordDRG Forum: 2015-04-08
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Problem
Cases with unusual combination as intpatients get assigned to DRG 470 in NordDRG Est (2014)
Analysis
Clinical analysis
Any combination that in short therapy is assigned to DRG 477O seems to be assigned to DRG 470. This is obviously wrong although there is in many cases some problems in coding.
Economic analysis
Technical problem, no economical analysis needed.
Suggestion
The reason for this problem is that the rule ord 499D001900 (from NordDRG COM 2013) has disappeared in NordDRG 2014. Therefore all cases are assigned by the next (and last) rule ord 999D002 to DRG 470X. This is an obvious mistake that has been unnoticed. The rule is retained in all national logic versions and the error affects thus only Est, Lat and Com versions.
Technical change
The rule ord 499D001900 (from NordDRG COM 2013) must be restored as soon as possible.
The NordDRG Est 2014 must be also corrected from the archive version.
DRG change
The inpatient cases with unusual (not major) intervention-diagnosis combination will be assigned to DRG 477 instead of DRG 470.

History

#1 Updated by Liselotte Säll over 4 years ago

2015-04-08

Error corrected. New version EST2014PR1eF is ready in the usual place.

#2 Updated by Kristiina Kahur over 4 years ago

2015-04-08 Kristiina Kahur

Thank you for your work :)

#3 Updated by Kristiina Kahur over 4 years ago

2015-04-09 Kristiina Kahur

After receiving the def.tables of EST2014PR1eF it came clear that the rule ord 499D001900 is not the second last but third last in EST2014PR1eF. The second last is 499D999999 and it concerns tracheostomy.
499D001900 477 Harv diagnoosi ja muu operatsiooni kombinatsioon
499D999999 483 Trahheostoomia
999D002 470 Ei grupeeru

I think it is not correct and should correct once again so that the order of last three ord were as follows:
499D999999 483 Trahheostoomia
499D001900 477 Harv diagnoosi ja muu operatsiooni kombinatsioon
999D002 470 Ei grupeeru

#4 Updated by Anonymous over 3 years ago

  • Target version set to Expert Group 2016

#5 Updated by Martti Virtanen over 3 years ago

  • Status changed from Active to Accepted

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