Case #500

C624 Diagnoses which may not be main diagnos

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

Status:ActiveStart date:2016-12-29
Priority:MinorSpent time:-
Assignee:Susann Berggren
Category:-
Target version:Expert Group 2017
Initiator:Sweden Target year:2018
Case type:Minor Owner / responsible:National organisations
MDC:CC, GEN, MDC01, MDC02, MDC03, MDC04, MDC05, MDC06, MDC07, MDC08, MDC09, MDC10, MDC11, MDC12, MDC13, MDC14, MDC15, MDC16, MDC17, MDC18, MDC19, MDC20, MDC21, MDC22, MDC23, MDC24, OR Old forum status:
Target Grouper:SWE

Description

Description:

National ID: C624
Initiated: 2016-11-25
Initiator: Susan Berggren, The National Board of Health and Welfare, Sweden

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Problem
We've got the list from Classifications and Terminology (KLT) with diagnoses which may not be the main diagnosis. When we compared the codes we found that there were 8 codes that was missing, listed below. These codes have different dgcat. We want the dgcat to be changed to 99M00 (code may not be used as a principal diagnosis).

Analysis
The National Board of Health and Welfare, Sweden 2016-11-25

We want these codes to have a the new dgcat 99M00
Z 51.5 Palliative care
Z 53.0 Procedure not completed due to contraindication
Z 53.1Procedure not completed due to the patient's decision of religious reason or group pressure
Z 53.2 Procedure not completed due to the patient's decision for other, non-specified reasons Z 53.8 Procedure not completed due to other specified reasons
Z 53.9 Procedure not completed due to non specified reasons
U04 Severe acute respiratory syndrome [SARS]
U 04.9 Severe acute respiratory syndrome [SARS], unspecified

Suggestion

The National Board of Health and Welfare, Sweden
Remove the old dgcat from the codes above and insert 99M00 to these 8 codes.

If the other countries do not accept this change, Sweden wants to add a pdgprop “23P01 Non-defined diagnosis” to these codes and then changes the name to“23P01 Non-defined diagnosis or invalid primary diagnosis”.

Decided changes
The National Board of Health and Welfare, Sweden
Sweden wants this changes to be introduced for the Swedish NordDRG 2018

DRG change
After the changes these codes cant not be main diagnosis


Technical change

Insert 99M00 to these 8 codes:
Z 51.5 Palliative care
Z 53.0 Procedure not completed due to contraindication
Z 53.1 Procedure not completed due to the patient's decision of religious reason or group pressure
Z 53.2 Procedure not completed due to the patient's decision for other, non-specified reasons
Z 53.8 Procedure not completed due to other specified reasons
Z 53.9 Procedure not completed due to non specified reasons
U04 Severe acute respiratory syndrome [SARS]
U 04.9 Severe acute respiratory syndrome [SARS], unspecified.

Or add a new pdgprop 23P01 Non-defined diagnosis, and changes the name to:
23P01 “Non-defined diagnosis or invalid primary diagnosis”

C 624 TC to NCC alternaty 1.xlsx (14.3 KB) Tiina Pasanen, 2016-12-29 10:06

Case 624 TC to NCC alternaty 2.xlsx (15.5 KB) Tiina Pasanen, 2016-12-29 10:06

TC for #500 C624.xlsx (20.1 KB) Ralph Dahlgren, 2017-04-11 11:37

History

#1 Updated by Kristiina Kahur 9 months ago

Finnish National DRG-Centre 2017-2-10

Finland does not have such a rules which would limit the use of certain codes as main diagnosis. The exeption would be Z51.5 Palliative care, but it is too early to change the rule in 2018.
Good idea but not applicable for Finland.

#2 Updated by Kristin Dahlen 8 months ago

We do not support this change, as all these codes might be used as main diagnosis in Norway.

Reprinted from the Norwegian coding rules:
Z53.-
"Dersom en pasient kommer for behandling og behandlingen avlyses uten at det gjøres noe annet med pasienten brukes en kode fra kategorien Z53 for hovedtilstand og sykdommen som annen tilstand, f.eks. når en operasjon utsettes pga. kapasitetshensyn."

According to information from The Norwegian Directorate of eHealth who is responsible for the primary codes it is a suggestion in WHO to move the code for SARS to Chapter J. The more preliminary U049 code will then be replaced. This might take place from 2019.

#3 Updated by Martti Virtanen 8 months ago

2017-03-09 Martti Virtanen
It is not possible to have a different diagnosis category for a code mapped together with other national codes. Thus this cannot be solved in the current structure separately for Sweden.
My primary proposal is that yoy solve this int patient administrative systems on hospital level.

#4 Updated by Susann Berggren 8 months ago

2017-03-09 Susan Berggren NPK, Sweden
Look at our suggestion 2

#5 Updated by Ralph Dahlgren 7 months ago

2017-04-11.
At the Expertmeeting march 2017 it was decided that the suggestion number 2 was accepted. Sweden has therefore made specific technical changes for suggestion 2 that is included today. They are called “TC #500 C624.xls”

#6 Updated by Martti Virtanen 6 months ago

2017-03-13 Expert group
Accepted according to model 2 from Sweden
Technical changes written by Ralph Dahgren are valid. The property is given to the linked ICD+ and thus to all versions but since this new property is not used by any other NordDRG version than Swe, the change will not affect aother versions.

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