|Target version:||Target version 2017|
|Case type:||Minor||Owner / responsible:||National organisations|
|MDC:||MDC12||Old forum status:|
A needle biopsy of the prostate can be done in various indications, for example malignant tumor of the prostate. Along with procedure code KEX06 Needle biopsy of the prostate together with ZXM00 image-guided technique using ultrasound the DRG is 812P Minor procedures on male genitals. This seems logical.
A needle biopsy of the prostate can also be performed in a contact were the indication will be R74.8 abnormal serum levels of other specified enzymes. The contact will then group to DRG 923O. This seems illogical, as long as we are talking about the same procedure.
Norwegian Directorate of Health – 2016-04-11
We want these cases with main condition R74.8 and procedure codes KEX06 needle biopsy of the prostate to group to DRG 812P as well as the cases with main diagnosis malignant tumor of the prostate.
The mentioned cases will move from DRG 923O to DRG 812P.
A new rule for DRG 812P with for example ORD 123D01015 (in between former rule 123D01003 and 124D000000), with MDC=23 and PROCPR=12O01.
#1 Updated by Martti Virtanen over 3 years ago
- File Technical changes case #482.xls added
- Status changed from Active to Further active
2016-05-23 Martti Virtanen - Nordic Casemix Centre
This case was sent too late to be discussed at Expert group meeting 2016.
The change will, however, only affect NordDRG Nor.
The proposal is somewhat incomplete. It affects all cases with a combination of interventions with the property 12O01 and principal dx from MDC 23. They are listed in the proc (and NCSP+) and dg (and ICD+)sheets of the technical changes. Although the number of codes is huge, the combinations are quite rare. Some of the combinations may actually be relevant in the light of this case but others may cause unwanted effects.
Since the change affects only logic table, it will only affect NordDRG Nor. Thus we will do the change, but I hope Norway will check the effects in the light of this discussion.
The case will remain ope to allow discussion about it.
#4 Updated by Kristiina Kahur over 2 years ago
Finnish National DRG-centre 2017-3-6
It is not clear how the change has been implemented in NOR version without any discussion in Expert group.
Nevertheless, we would be interested in discussing the case and possible change in Finnish version.
In Finnish data the # of cases with code KEX06/KEXX00/TKE00 Prostate needle biopsy is 147, out of which 134 cases in DRG 923O, mean cost 635 EUR.
Mean cost of DRG 923O (all cases) is 235 EUR.
Mean cost of DRG 812O (812P in Norway) where the KEX06 cases would possibly be moved to is 523 EUR.
So it would make sense to move the cases with KEX06 to 8-series group.