Case #561

Postoperative control of malignant melanoma

Added by Veronika Stemme over 2 years ago. Updated about 1 year ago.

Status:AcceptedStart date:2017-11-28
Priority:MinorSpent time:-
Assignee:Veronika Stemme
Category:-
Target version:Target version 2019
Initiator:Sweden Target year:2019
Case type:Minor Owner / responsible:National organisations
MDC:MDC09 Old forum status:
Target Grouper:SWE

Description

Problem
If a postoperative control of a malignant melanoma is coded with ICD-10 codes
Z080 Follow-up examination after surgery for malignant neoplasm + C430 Malignant melanoma of lip
the case will go to DRG J99 Övriga läkarbesök vid sjukdomar i hud och underhud, ej komplicerat, but if the same case is coded with Z089C Kontrollundersökning efter behandling för malignt melanom i huden (Follow-up examination after unspecified treatment for malignant neoplasm of the skin) the case is grouped to the unspecific DRG W99O (884) Övriga läkarbesök vid andra problem . We think that the codes
Z089A Kontrollundersökning efter behandling för basalcellscancer
Z089B Kontrollundersökning efter behandling för skivepitelcancer i huden
Z089C Kontrollundersökning efter behandling för malignt melanom i huden
should all lead to DRG J99.
When looking at the codes for follow-up examinations we also noted that the code Z093Kontrollundersökning efter psykoterapi should lead to DRG T99 (880) Övriga läkarbesök vid psykiska besvär och drogberoende.

Suggestion
We suggest that the ICD-10 codes
Z089A Kontrollundersökning efter behandling för basalcellscancer
Z089B Kontrollundersökning efter behandling för skivepitelcancer i huden
Z089C Kontrollundersökning efter behandling för malignt melanom i huden get the DgProp 09X99 ’Diseases and disorders of the skin and subcutaneous tissue’ and that the ICD-10 code Z093’Kontrollundersökning efter psykoterapi’ gets the DgProp 19X99 ‘Mental diseases and disorders’

DRG change
Cases with the ICD-10-codes Z089A, Z089B and Z089C will be directed to DRG J99 ’Övriga läkarbesök vid sjukdomar i hud och underhud, ej komplicerat’ instead of DRG W99O (884) Övriga läkarbesök vid andra problem.
Cases with the ICD-10-code Z093 will be directed to DRG T99 (880) ’Övriga läkarbesök vid psykiska besvär och drogberoende’ instead of DRG W99O (884) ’Övriga läkarbesök vid andra problem’.

Technical changes CPK-ID722.xlsx (14.9 KB) Veronika Stemme, 2017-11-28 12:08

Technical changes case #561.xlsx (21.7 KB) Martti Virtanen, 2018-03-12 10:17

History

#1 Updated by Kristiina Kahur about 2 years ago

Finnish National DRG-Centre 5-1-2018

There is no subcodes of Z089 in ICD10 version used in Finland as it is in Sweden. In Finnish ICD10 version, there is only Z089 Follow-up examination after unspecified treatment for malignant neoplasm/Kontrollundersökning efter icke specificerad behandling för malign tumör which does not specify the location of the tumor and therefore it is ok, if the cases with main diagnosis Z089 group to DRG 923O. If the specific tumor code from ICD10 chapter C is coded as secondary diagnosis, then the case is grouped to respective DRG based on the location of the tumor.
The other part of the suggestion is relevant for Finland and we support adding DgProp 19X99 ‘Mental diseases and disorders’ to ICD10 code Z093.

#2 Updated by Martti Virtanen about 2 years ago

2018-02-26 Martti Virtanen
The properties of type **X99 are automatically created codes that are given to all dx's in the coresponding MDC. Thus all MDC 09 dx's are given the property 09X99.
In ICD-plus the codes Z089A/B/C only exist in Sweden. They have there own ICD-plus codes. These codes belong to diagnosis category 23M04 'Follow-up'. Since they obviously indicate a skin disease, it is simple to assign them to dgcat 09M99 'Minor skin disorders' instead. The indicated cases would be assigned to MDC specific DRG's as proposed.
In addition cases with these interventions would be assigned to MDC specific surgical DRG's if apropriate interventions have been registered.

#3 Updated by Martti Virtanen about 2 years ago

  • File Technical changes case #561.xlsx added

#4 Updated by Veronika Stemme almost 2 years ago

Veronika Stemme, NPK, Sweden
We accept Marttis solution with exchanges of DgCat:s for the mentioned diagnosis, but the diagnosis Z089A ‘Kontrollundersökning efter behandling för basalcellscancer’ is lacking in Marttis Technical changes and the diagnosis Z090 ‘Follow-up examination after surgery for other conditions’ is added. We want Z089A to have the same DgCat (09M99) as Z089B and Z089C. We do not want Z090 to have Dg Cat 09M99 since this diagnosis can be used for many other conditions than skin diseases.
Will the diagnosis automatically also get DgProp 09X99 (Z089A, Z089B and Z089C) and 19X99 (Z093) respectively when the DgCat:s are changed?

#5 Updated by Martti Virtanen almost 2 years ago

2018-03-12 Martti Virtanen
This is typing error, corrected now.

#6 Updated by Martti Virtanen almost 2 years ago

  • File deleted (Technical changes case #561.xlsx)

#7 Updated by Martti Virtanen about 1 year ago

  • Status changed from Active to Accepted

2018-03-13 Expert group
Accepted according to the technicahttp://documents.norddrg.net/issues/561/editl changes. The **X99 properties are created automatically. The subcodes at issue are currently only used by Sweden.

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