Case #493

Dilatation and curettage of cervix uteri is not performed without anesthesia

Added by Tiina Pasanen 10 months ago. Updated 7 months ago.

Status:ActiveStart date:2016-12-16
Priority:MinorSpent time:-
Assignee:Veronika Stemme
Category:-
Target version:Expert Group 2017
Initiator:Sweden Target year:2018
Case type:Minor Owner / responsible:National organisations
MDC:MDC13 Old forum status:
Target Grouper:COMMON

Description

Description:

National ID: CPKID 663
Initiated: 2016-11-07
Initiator: Veronika Stemme, The National Board of Health and Welfare, Sweden

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Problem
The procedure codes LDA00 'Dilatation of cervix uteri ' and LDA10 ’Curettage of cervix uteri' lead to DRG O99O ’Övriga läkarbesök vid sjukdomar i genitalia hos kvinna’ by themselves. But if a procedure code for anesthesia is added, for example SK529 Paracervikalblockad UNS, they are instead grouped to DRG O30O ’Skrapning och konisering , öppenvård’. Since the procedures LDA00 and LDA10 are always performed with anesthesia they should be grouped to DRG O30O ’Skrapning och konisering , öppenvård’ without the addition of a code for anesthesia.

Analysis
The National Board of Health and Welfare, Sweden – 2016-11-07
This is a question of medical description, but economical analysis support the suggestion. The mean cost in DRG O30O was analysed with and without code for paracervical block (procedure codes SK520’Paracervikalblockad utan kateter’, SK521’Paracervikalblockad med kateter’, SK522’Paracervikalblockad med tunnelerad kateter’ or SK529’Paracervikalblockad UNS’. The cases with paracervical block was 31% more expensive (mean cost, all cases) than the cases without these codes, se file “PCB in DRGO30O.xlsx”

Suggestion
The National Board of Health and Welfare, Sweden – 2016-11-07
The procedure codes LDA00 'Dilatation of cervix uteri’ and LDA10 ‘Curettage of cervix uteri' should be given OR1 instead of OR2. This change is added to the Proc1 column.

Decided changes
The National Board of Health and Welfare, Sweden – 2016-11-07
Sweden wants this change to be introduced in the Swedish NordDRG 2018.

DRG change
The procedure codes LDA00 'Dilatation of cervix uteri’ and LDA10 ‘Curettage of cervix uteri' now lead to DRG O99O ’Övriga läkarbesök vid sjukdomar i genitalia hos kvinna’ if not a procedure code for anesthesia is added.
After the change they will instead be grouped to DRG O30O ’Skrapning och konisering , öppenvård’ without the need to add a code for anesthesia.

Technical change
The procedure codes LDA00 'Dilatation of cervix uteri’ and LDA10 ‘Curettage of cervix uteri' are given OR=1 instead of OR=2. This change is added to the Proc1 column.
Se file ‘Technical changes CPKID 663.xlsx’

PCB in DRGO30O.xlsx (11.1 KB) Tiina Pasanen, 2016-12-16 10:39

New Technical Changes Decisions #493, C663.xlsx (20.5 KB) Veronika Stemme, 2017-03-28 15:06

History

#1 Updated by Martti Virtanen 7 months ago

  • Description updated (diff)

#2 Updated by Veronika Stemme 7 months ago

Veronika Stemme, Sweden:
Since the change should only be implemented for Sweden and Norway, we have made new technical changes with no change of OR-property.
Instead, a new row for DRG O30O/364O is created in DRG-logic, and the procedure codes LDA00 and LDA10 gets a new proc prop: 13V07 ‘Cervix interventions’.

#3 Updated by Veronika Stemme 7 months ago

  • File deleted (Technical changes CPKID 663.xlsx)

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