Case #476

KBE22 OR property correction

Added by Malle Avarsoo about 4 years ago. Updated over 3 years ago.

Status:AcceptedStart date:2016-02-26
Priority:Error correctionSpent time:-
Assignee:Malle Avarsoo
Category:-
Target version:Expert Group 2016
Initiator:Estonia Target year:2017
Case type:Error correction Owner / responsible:National organisations
MDC:OR Old forum status:
Target Grouper:EST

Description

NCSP codes KBE12 and KBE22 have different OR properties and give different grouping both in short stay and regular stay if used ( i.e. with princicpal dgn code N20.0 )

If KBE22 (Transluminal endoscopic dislodgement of impacted calculus from ureter = OR 2) is used, the grouper gives DRG 324 or 716O ( depending on lenght of stay)
If KBE 12 (Transluminal endoscopic extraction of calculus of ureter = OR 1 ) is used, gouping will be 311 or 311O .

This result is not clinically correct, as both NCSP-s refer to endoscopic (surgical) procedure, and should be with same OR property 1.

We suggest OR 2 for KBE22 will be changed to OR 1.

Decision C645.xlsx (15.2 KB) Mats Fernström, 2016-03-17 14:56

Technical changes #476.xlsx (18.4 KB) Martti Virtanen, 2016-03-23 14:34

History

#1 Updated by Kristiina Kahur almost 4 years ago

Finnish National DRG-Centre 2016-2-25

There are the same properties for procedures codes KBE22 and KBE12 and also the same grouping rules for DRG 311 and 311O in Finnish version as in Estonian one.
The difference between two versions is that in Estonian version the anesthesia codes with property 00X10 (General anesthesia) are not in use and the rules referring to anesthesia (111D0901 and 411D0921) are basically never used in Estonian version. Therefore the inpatient cases with procedure code KBE22 will not group to DRG 311 and end up in DRG 324 instead (311O and 716O in outpatient settings respectively).
It would make sense to change the OR property of procedure code KBE22 in Estonian version unless the anesthesia codes will be introduced in NCSP Estonian version asap.

#2 Updated by Anonymous almost 4 years ago

  • Target version set to Expert Group 2016

#3 Updated by Mats Fernström almost 4 years ago

Mats Fernström, NPK, Sweden, 2016-03-01
KBE22 is hardly possible without greater anaesthesia which adds 00X10 to the case so, if correct coded, most cases in Sweden will already be grouped to DRG M15 (310/311). Thus, changing the OR property from 2 to 1 will not have any great impact in Sweden. We also think that KBE22 and KBE12 are rather similar in resource consumption. In summary - we support the suggestion that OR 2 for KBE22 is changed to OR 1 but we want to add that then the property 11E16 can be deleted from KBE22. 11E16 will have no effect if KBE22 gets OR 1.

#4 Updated by Kristin Dahlen almost 4 years ago

We support the suggestion of changing from OR 2 to OR 1 for procedurecode KBE22.

#5 Updated by Mats Fernström almost 4 years ago

Mats Fernström, NPK, Sweden, 2016-03-17
This proposal was discussed at the Expert Network meeting 2016-03-14 – 15 and was accepted, but technical changes according to the NCC template were missing. The attached file Decision C645.xlsx shows the technical changes for the SWE version.

#7 Updated by Anonymous over 3 years ago

  • Status changed from Active to Accepted

Also available in: Atom PDF