Case #546

Therapeutic venesection

Added by Kristin Dahlen over 4 years ago. Updated over 4 years ago.

Status:RejectedStart date:2017-02-24
Priority:MinorSpent time:-
Assignee:Kristin Dahlen
Category:-
Target version:Target version 2018
Initiator:Norway Target year:2018
MDC:GEN Owner / responsible:National organisations
Target Grouper:NOR Old forum status:

Description

National ID: HD-177
Initiated: 2017-02-20
Initiator: The Norwegian Directorate of Health

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Problem
In Norway we have DRG 817S Fullblodstapping eller uttak av beinmarg. This DRG may to some extent correspond to DRG 817O in the common version. This DRG covers the therapeutic venesection done on indications in MDC 17.

Therapeutic venesection (procedurecode RXGX05 terapeutisk fullblodstapping) performed on patients with diagnosis not belonging to MDC 17 is grouped to different 9## DRGs (for example DRG 910O Kontakt vedr andre endokrine/ ernærings-/ stoffskiftesykdommer or 916O Poliklinisk konsultasjon vedr sykdommer ved bloddannelse eller i immunsystemet).

Due to a Norwegian rule for health personell in activity base funding, therapeutic venesection conducted by bioengineers will not be refunded unless the main condition is in MDC 17. Besides this we think it would be a good idea to have an equal DRG logic for all the therapeutic venesections performed on outpatients.

Analysis
The Norwegian Directorate of Health – 2017-02-20

Suggestion
The Norwegian Directorate of Health – 2017-02-20
We want to make DRG 817S open for cases with main condition in MDC 10 and MDC 16.The DRG shall be placed in MDC 40 Kategorier på tvers av flere hoveddiagnosegrupper.

Technical change

History

#1 Updated by Martti Virtanen over 4 years ago

2017-06-08 Martti Virtanen
This case seems to affect the Norwegian version only. Technically it should not be a major problem.
It is still important to remind that this is a step towards fee-for-service model and as such creating a wrong incentive.
I urge Norway to write the technical changes for this case, since it is critical where you but the the new rules in the logic.

#2 Updated by Martti Virtanen over 4 years ago

  • Status changed from Active to Rejected

2017-03-13 Expert group
NOR wants to postpone the case. It will be closed now, NOR can reactivate the case any time needed.

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