Case #499

P94 Disorders of muscle tone, children >1 year

Added by Tiina Pasanen 10 months ago. Updated 4 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:MDC01, MDC15 Old forum status:
Target Grouper:COMMON

Description

Description:

National ID: CPK ID 653
Initiated: 2016-06-17
Initiator: Veronika Stemme, National Board of Health and Welfare, Sweden
----------------------------------------------------------------------------------------------------------------

Problem
The ICD-10-SE codes P941 (Medfödd muskelhypertoni, congenital muscle hypertonia) and P942 (Medfödd muskelhypotoni, congenital muscle hypotonia) can be relevant also in patients older than one year, but now cases with these diagnosis are grouped to DRG Z76N Patienten är för gammal för diagnosen eller åtgärden (The patient is too old for the diagnosis or procedure) if the patient is >1 year. The diagnosis P94.1 and P94.2 should be ok to use also for patients older than 1 year.

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
We suggest the following changes for P94.1 and P94.2:
Change MDC from 15 ‘Newborn And Other Neonates (Perinatal Period)’ to MDC01 ‘Diseases and Disorders of the Nervous System’.
Change DGCAT from 15M99 to 01M99.
For P94.1 change COMPL 15C01 (Neonatal complication) to 01C31 (Serious muscle disorder)

Decided changes
National Board of Health and Welfare, Sweden – 2016-12-05
Sweden wants the changes to be implemented in the Swedish NordDRG 2017.

DRG change
The ICD-codes P94.1 and P94.2 are now grouped to DRG Z76N if the patient is more than 1 year old. After the change P94.1 and P94.2 will be grouped to DRG A69E ‘Andra sjukdomar i nervsystemet, ej komplicerat’ irrespective of age.

Technical change
The following changes are suggested for ICD-codes P94.1 and P94.2:
Change MDC15 to MDC01
Change DGCAT from 15M99 to 01M99
For P94.1 change COMPL 15C01 to 01C31
Se file ‘Technical changes CPK ID 653’

Technical changes CPK ID 653.xlsx (16 KB) Tiina Pasanen, 2016-12-22 13:05

Updates for #499 C653 20170427.xlsx (18.1 KB) Ralph Dahlgren, 2017-04-27 17:07

Technical changes case #499.xlsx (17.8 KB) Martti Virtanen, 2017-05-08 12:31

History

#1 Updated by Kristiina Kahur 8 months ago

Finnish National DRG-centre 2017-3-6

52% of patients with main dx P94.1 or P94.2 are more than 1 year old and the cases group to DRG 470Q (short therapy) or 470B (inpatient).
We support the change in principle.
Just would like to clarify whether the DGCAT 01M99 exists in Swedish version only? There is no such DGCAT in Finnish version.

#2 Updated by Kristin Dahlen 6 months ago

We would like to repeat Kristiinas question about the DGCAT 01M99, we do not have it in the Norwegian version either. If it is a new property, what should be the name of it?

#3 Updated by Mats Fernström 6 months ago

Mats Fernström, NPK, Sweden, 2017-04-25.
DGCAT 01M99 exists in all versions and the text is "Other disorders of the nervous system". For some reason the DGCATs ending with M99 are not listed in the table DG CATEG (except 09M99)but you can find them in the table DG_1.

#4 Updated by Kristiina Kahur 6 months ago

Kristiina Kahur/Finnish National DRG-centre 2017-4-25

Thanks, Mats. DGCAT 01M99 is in dg_1 sheet indeed.
Unless there is no particular restriction, the DGCAT 01M99 should be added to dg_categ sheet too in def.tables. Hopefully Liselotte can take care of it in PL version.

#5 Updated by Ralph Dahlgren 6 months ago

2017-04-27 2017-04-27 Ralph Dahlgren
This is a response to Kristiina Kahur comment 2017-04-25
Sweden completely agree with Finland that all the DG CAT that are in the table “dg1 should be in the table “dg categ”. This to make the tables easier to understand. As everyone already probably know most of the ??M99 are not in the table drglogic but they are in the table dg1 with no text.
There is no particular reason why DGCAT 01M99 and the rest of them are not included into the dg_categ sheet. Then everyone can find them with the texts as well.
I know Liselotte can put them in, the question is if they stay there.
So here comes a updated technical changes file that includes all the ??M99 that I could find in the table “dg” in the new a wonderful common that Martti made for us.

#6 Updated by Kristiina Kahur 6 months ago

Kristiina Kahur/Finnish Natioanl DRG-centre 2017-4-27

Thanks Raplh for reply and technical changes.

#7 Updated by Martti Virtanen 6 months ago

2017-03-13 Expert group
Accepted as proposed by Swe, dx changed from MDC15 to MDC01.

#8 Updated by Martti Virtanen 6 months ago

2017-05-08 Martti Virtanen
Technical changes for combined version included.
There was a technical error - the residual diagnosis categoeries that are not included in the Drglogic where not included in the diagnosis category (dgcat) tables. This is now corrected.

#10 Updated by Martti Virtanen 4 months ago

2017-06-14 Martti Virtanen
Based on a question from Finland I remaind everybody that this change will not affect patient cases of newborns i.e. addmitted during the first week of life or with certain exceptions during first month of life. There the specific rules for neonatal DRG's take precedence.

Also available in: Atom PDF