Case #497

Outpatient ECT to RG T76O/877V - Electroconvulsive Therapy

Added by Tiina Pasanen 10 months ago. Updated 6 months ago.

Status:ActiveStart date:2016-12-22
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:MDC19 Old forum status:
Target Grouper:SWE

Description

Description:

National ID: CPK ID649
Initiated: 2016-01-01
Initiator: Veronika Stemme, National Board of Health and Welfare, Sweden

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Problem
Electroconvulsive Therapy (ECT) in outpatient care should always be grouped to DRG T76O/877V - Electroconvulsive Therapy - irrespective of if anesthesia is coded or not. At present, if a code for general anesthesia is added ECT-cases are grouped to T01O (Operationer el. andra åtgärder i större anestesi vid psykiska besvär, öppenvård = Operations or other procedures in general anesthesia in cases of mental disorders, outpatient care).

Analysis
National Board of Health and Welfare, Sweden – 2016-12-05
This is a matter of medical description, economical analysis is not needed.

Suggestion
National Board of Health and Welfare, Sweden – 2016-12-05
SECPROC "-19V02" (-Electroconvulsive therapy) is added to DRG T01O.

Decided changes
National Board of Health and Welfare, Sweden – 2016-12-05
Sweden wants this changed implemented in the Swedish NordDRG 2018.

DRG change
Outpatient cases with ECT is now grouped to T01O if a procedure code for anesthesia is added. After the change all outpatient cases with ECT will be grouped to T76O.

Technical change
SECPROC "-19V02" (-Electroconvulsive therapy) is added to the rule for DRG T01O
Se file ‘Technical changes CPK ID 649.xlsx’

Technical Changes CPK ID 586.xlsx (14.1 KB) Tiina Pasanen, 2016-12-22 12:55

Technical changes case #497.xlsx (70.2 KB) Martti Virtanen, 2017-05-08 14:34

History

#1 Updated by Martti Virtanen 6 months ago

2017-03-13 Expert group
Accepted as proposed

#2 Updated by Martti Virtanen 6 months ago

  • File Technical changes case #497.xlsx added
  • Subject changed from Outpatient ECT to DRG T76O to Outpatient ECT to RG T76O/877V - Electroconvulsive Therapy
  • Description updated (diff)

2017-05-08 Martti Virtanen
The expressed wish in this case is 'Electroconvulsive Therapy (ECT) in outpatient care should always be grouped to DRG T76O/877 - Electroconvulsive Therapy'.

The current rule for DRG 877V/T76O has ord (and id) 200D123000. It is located at the beginning of the Swedish outpatient rule set. The proposed change expects the cases to be assigned accoring to this rule when the ECT (19V02) is forbidden for rules 119D0000001 and 119D0000011 (id's and ord's). However, in between are a large number of rules out of which at least those that do not specify any MDC or diagnosis property (marked with grey in Drglogic of the technical changes table set) can certainly be assigned to other DRG's than T70/877V. This occurs when the ECT is combined with other interventions.
The DRG 877V/T76O is for all cases irrespectively of the MDC. Obviously in othe MDC's than 19 the modification will not change the assigment to DRG's in the those MDC's.

If assignment of all ECT cases should be in DRG 877V/760O the rule might need modification.

The attached technical changes document includes the questionable rules (most of them anyway). When filtered with yellow, it gives just the directly affected rules.

In addition, there is a Finnish rule for DRG 424O that has a technical that shall be corrected. One can see it by filtering for 'IN' and 'OUT*

#3 Updated by Veronika Stemme 6 months ago

Veronika Stemme, Sweden
In theory we agree that there is a risk that cases with ECT combined with another procedure gets assigned to a DRG above T76O in the hierarchy. However, in reality we think it should not be a problem since ECT in outpatient health care is rarely combined with other procedures during the same visit.

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