Case #550

Coding of Candida oesophagitis

Added by Martti Virtanen over 4 years ago. Updated almost 4 years ago.

Status:RejectedStart date:2017-04-04
Priority:MinorSpent time:-
Assignee:-
Category:-
Target version:-
Initiator:Nordic Casemix Centre Target year:2018
MDC:CC Owner / responsible:National organisations, Nordic Casemix Centre
Target Grouper:SWE Old forum status:

Description

Initiated: 2017-04-04
Initiator: Martti Virtanen: Nordic Casemix Centre
Responsible at National organization: Martti Virtanen: Nordic Casemix Centre
Sent to NordDRG Forum: 2017-04-04
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The coding of Candida oesophagitis causes problems with DRG assignment rules.
Sweden has created to B378D ‘Candida oesophagitis' a subcategory D378 ' Candidiasis of other sites' that includes candida cheilitis and enteritis.
The most specific single code for this condition in ICD-10 is B378. If more specificity is demanded the most accurate coding is K238*B378 where K238 is ‘Disorders of oesophagus in other diseases classified elsewhere'.
In the ICD+ the Swedish code B378D is linked to K2380*B3780.
This means that diagnosis category is taken from K2380 if not overruled by a specific definition for the pair.
Other properties (Dgkat, dgprop, are taken from both linked ICD+ -codes but additional properties can be defined for the pair only.
Exclusions of complication categories are taken from the ICD+ - codes but additional exclusions can be defined for the pair. [Diagnosis belonging to a complication category (any level G/C/I) cannot complicate the case with the dx at issue as principal dx if this dx is on the exclusion list for that complication category.]
Problem
The problem, if any, is in this case the complication categories.
Sweden has defined B378 to belong to complication category 18G04 i.e. 1804 on G-level (MCC). B378D is defined to belong to 18C04 i.e. 1804 on C-level.
B378D includes (as only named locations) cheilitis and enteritis. It seems not logical that the oesophagus is not G-level when the others are.
The other problem is that the CC-level cannot be lowered by a specific definition fir a pair. B378D is a pair since the original postcordinated WHO coding can be used also in Sweden – both codes are available. Even B378 alone can be used for oesophagitis.
Suggestion
Either B378D should be changed to 18C04 or B378D should be 18G04.

History

#1 Updated by Ralph Dahlgren over 4 years ago

2017-04-11. If we in Sweden understand this case correctly it correspond to the old NCMC case #434 that was postponed in the Expertgroupmeeting march 2017. Maybe Close this case and let the old one, #434, stay as it is.

#2 Updated by Martti Virtanen almost 4 years ago

See case #434,

#3 Updated by Martti Virtanen almost 4 years ago

  • Status changed from Active to Rejected

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