Case #498

Coronary angio with measurement of intra-arterial pressure

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:MDC05 Old forum status:
Target Grouper:COMMON

Description

Description:

National ID: CPK IDC656
Initiated: 2016-06-02
Initiator: Veronika Stemme, National Board of Health and Welfare, Sweden


Problem
In outpatient care the procedure code AF037 ‘Koronarangiografi (i)’ leads to DRG E45O ’Cirkulationssjukdomar med hjärtkateterisering, öppenvård’, but if a code for measurement of intra-arterial pressure, AF050 ‘Mätning av intrarteriellt blodtryck (i)’ is added the case is instead grouped to DRG E39O ‘Andra åtgärder vid sjukdomar i cirkulationsorganen, öppenvård’ which gives less specific medical information. The addition of AF050 to AF037 should not change the grouping.

Analysis
National Board of Health and Welfare, 2016-12-05
This is a matter of medical description.
The prospective weights for the two DRG:s in Sweden, for 2017, are very similar (E45O= 0,298 and for E39O= 0,295).

Suggestion
National Board of Health and Welfare, 2016-12-05
We propose that DRG E45O is moved above DRG E39O in DRG-logic.

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

DRG change
Cases with the procedure code AF037 ‘Koronarangiografi’ and the additional code AF050 ‘Mätning av intrarteriellt blodtryck (i)’ are now grouped to DRG E39O‘Andra åtgärder vid sjukdomar i cirkulationsorganen, öppenvård’. After the change these cases will instead be grouped to DRG E45O’Cirkulationssjukdomar med hjärtkateterisering, öppenvård’

Technical change
DRG E45O is moved above DRG E39O by changing ORD-value from 105D230000 to
105D194900.

Technical changes CPK ID 656.xlsx (13.6 KB) Tiina Pasanen, 2016-12-22 13:01

Technical changes case #498.xlsx (19.5 KB) Martti Virtanen, 2017-05-08 12:51

History

#1 Updated by Kristiina Kahur 9 months ago

Finnish National DRG-Centre 2017-1-30

In order to analyse the case, what would be the respective NCSP+ code for AF050 Mätning av intrarteriellt blodtryck?
In NCSP+ 2017 file the code AF050 is currently mapped with PXXA00 Arterial puncture, which seems to be not correct. Would it be more accurate to use NCSP+ code FXF103 Direct intraarterial blood pressure measurement?
Thanks.

#2 Updated by Veronika Stemme 9 months ago

Veronika Stemme, Sweden. 2017-02-01
Yes, the swedish procedure code AF050 ’Mätning av intrarteriellt blodtryck’ is better translated to FXF103 ‘Direct intraarterial blood pressure measurement’.

#3 Updated by Martti Virtanen 8 months ago

2017-03-09 Martti Virtanen
I will correct the mapping of AF050.
The proposal has clear effets on Finish and Norwegian versions. Are those changes OK?

#4 Updated by Kristiina Kahur 8 months ago

Finnish National DRG-centre 2017-3-9

Code AF037/FNDC1A/FN1AC has been coded ca 12000 times in 2015, 13 times the cases has grouped into DRG 120O and four times into DRG 125O.
Code AF050/FXF103/XF603 has been coded ca 2700 times, just one case grouped into DRG 120O.
Both codes together appear 53 times, out of those no single case goes to DRG 120O.
Based on that, the change would have no effect on Finnish data unless the content of the suggestion has got wrong. From clinical point of view the suggested change would make sense.

As for cost weight E45O->125O Diagnostic percutan cardiac procedure, short therapy, has cost-weight 3,5300, and E39O->120O Other circulatory system o. r. procedures, short therapy, has cost-weight 1,7100

#5 Updated by Martti Virtanen 6 months ago

2017-03-13 Expert group
Accepted as proposed

#6 Updated by Martti Virtanen 6 months ago

2017-05-08 Martti Virtanen
Technical changes for the combined NordDRG.
The table includes the rules that might be affected by the grouping for your information.

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