Case #565

Change DGCAT för ICD-codes G94- and some G93-codes

Added by Veronika Stemme over 1 year ago. Updated 3 months ago.

Status:AcceptedStart date:2017-12-13
Priority:NormalSpent time:-
Assignee:Veronika Stemme
Category:-
Target version:Target version 2019
Initiator:Sweden Target year:2019
Case type:Minor Owner / responsible:National organisations
MDC:MDC01 Old forum status:
Target Grouper:SWE

Description

Problem The Swedish National Board of Health and Welfare, CPK-ID 730
We have found that the ICD-10-codes under G94- ‘Other conditions in the brain in diseases classified elsewhere’ have DGCAT 01M03 ’Degenerative nervous system disorders’, DGCAT 01M09 ’Infections except viral meningitis’ or 01M13 ‘Seizures and headaches’. We also found that the ICD-10-codes G932 'Benign intrakraniell hypertension' and G934 ‘Encephalopathy, unspecified’ have DGCAT 01M13 'Seizures and headaches'.
The codes (including hydrocephalus, encephalopathy, benign intracranial hypertension) are rather unspecific. Patients with these conditions do not necessarily have seizures, headaches, degenerative or infectious diseases according to the DGCAT they now have got. It seems more adequate that G94- , G932 and G934 instead get DGCAT 01M99 ’Other disorders of the nervous system’.

Analysis
This is a matter of medical description, no economical analysis is needed.

Suggestion
DGCAT 01M03 ’Degenerative nervous system disorders’, DGCAT 01M09 ’Infections except viral meningitis’ and 01M13 ‘Seizures and headaches’ are removed from the ICD-10-codes G94- and they get DGCAT 01M99 'Other disorders of the nervous system' instead.
DGCAT 01M13 'Seizures and headaches' is removed from the ICD-10-codes G932 'Benign intrakraniell hypertension' and G934 'Encephalopathy, unspecified' and these codes get DGCAT 01M99 'Other disorders of the nervous system' instead.

Decided changes
Sweden wants this change to be implemented in NordDRG 2019.

DRG change
Cases with ICD-10-codes G94- will be directed to DRG A99/758 ‘Other doctor visits in nervous system disorders’ instead of to DRG A44/012 ‘Doctor visits in degenerative disorders of the nervous system’, DRG A56/026 ‘Doctor visits in seizures and headaches’ or DRG A52/020 ‘Doctor visits in infections of the nervous system excluding viral meningitis’.
Cases with the ICD-10-codes G932 or G934 will go to DRG A99/758 ‘Other doctor visits in nervous system disorders’ instead of to DRG A56/026 ‘Doctor visits in seizures and headaches’.

Technical change
DGCAT 01M03 ’Degenerative nervous system disorders’, DGCAT 01M09 ’Infections except viral meningitis’ and 01M13 ‘Seizures and headaches’ are removed from the ICD-10-codes G94- and they get the DGCAT 01M99 'Other disorders of the nervous system' instead.
DGCAT 01M13 'Seizures and headaches' is removed from the ICD-10-codes G932 'Benign intrakraniell hypertension' and G934 'Encephalopathy, unspecified', these codes instead get DGCAT 01M99 'Other disorders of the nervous system'.
See file: Technical_changes_CPK-ID 730.xlsx

Technical changes case #565.xlsx (15.8 KB) Martti Virtanen, 2018-02-26 16:29

TC C730 #565 2018-03-26.xlsx (15.4 KB) Veronika Stemme, 2018-03-26 14:32

Technical changes case #565-2.xlsx (20.5 KB) Martti Virtanen, 2018-12-17 10:30

TC_#565_C730 2019-03-05.xlsx (12.8 KB) Mats Fernström, 2019-03-05 12:26

Technical changes case #565-3.xlsx (20.6 KB) Martti Virtanen, 2019-03-25 12:35

History

#1 Updated by Kristiina Kahur over 1 year ago

Finnish National DRG-Centre 8-1-2018

In Finnish version G94 has four subcodes with following DGCATs:
DGCAT 01M03 belongs to G940, G941, G942 and G948
DGCAT 01M09 belongs only to G948.
All those codes are used to describe the manifestation (marked with asterisk) and need dual coding. As indicated in case #296 (http://documents.norddrg.net/issues/296) “In NordDRG if a code pair is used and no special rule is defined, the diagnosis category (and MDC) are defined by the manifestation (asterisk) code.”. So it would make sense to revise the properties of G94- since they have impact on grouping.
Diagnosis codes G932 and G934 have the same DGCAT as in Swedish version.
In general, we agree and support the suggested change.

#2 Updated by Martti Virtanen over 1 year ago

2018-02-26 Martti Virtanen
The proposal is harmonizes the properties of the proposed codes and as such is straight forward.

However, the involved code pairs are somewhat problematic (as code pairs tend to be).

G4980*A5210 'Other specified disorders of brain in diseases classified elsewhere - Symptomatic neurosyphilis' is in practice almost identical in content with only A5210 'Symptomatic neurosyphilis'. It is odd, if coding G4980*A5210 would give other result than coding A5210. It is true, that there could be much longer list of categories and properties for specified pairs and therefore this defined pair is kind of exception. However, I would still retain the same category for A5210 and G4980*A5210.

The other listed situation is G4980*B5000 'Other specified disorders of brain in diseases classified elsewhere - Plasmodium falciparum malaria with cerebral complications'. B5000 'Plasmodium falciparum malaria with cerebral complications' is again almost identical with the pair. However, in his case B5000 belongs to category 18M99 'Other infectious and parasitic disease diagnosis'. For some reason in 2007 G4980 has been changed to 01M09 from 01M99 (which will be overruled now). Therefore G4890*B5000 dgcat 01M09 has become unnecessary (manifestation code has alread 01M09). In alliance with the syphilies-case, B5000 and G4980*B5000 should have identical diagnosis category and I would recommend 01M09.

Thus all single codes listed should have 01M99 but the pairs should have different properties.

#3 Updated by Veronika Stemme over 1 year ago

Veronika Stemme, NPK, Sweden
We agree with Marttis suggestion; DgCat 01M99 ‘Other disorders of the nervous system’ for the single codes and DgCat 01M09 ‘Infections except viral meningitis’ for the code pair G9480+B500 and for B500 as single code. We also think it is OK to retain 01M03 for the codepair G948+A521.

#4 Updated by Veronika Stemme about 1 year ago

  • File deleted (Technical_changes_CPK-ID 730.xlsx)

#5 Updated by Veronika Stemme about 1 year ago

Veronika Stemme, NPK, Sweden
According to Marttis suggestions we have omitted the dubbelcode G948+A521 from our technical changes and altered the changes for the dubbelcode G948+B500 and for B500 as single code.
We miss the single code G943 ’Encefalopati vid sjukdomar som klassificeras på annan plats’ in Marttis technical changes.

#6 Updated by Martti Virtanen 6 months ago

2018-03-13 Expert group
The case was accepted according to the proposal.

P.S. The dx G943 has been mapped to G4980 unti 1.1.2018. Now it has its own ICD+ code and must also be included in the list. This is corrected in the technical changes taht now also include the relevant ICD+ codes

#7 Updated by Ralph Dahlgren 4 months ago

2019-02-23 Ralph Dahlgren
When going through old cases Sweden noticed that some Changes has not been done according to the technical Changes. This is that the IDC-10 kodpair G948*B500+ should have DGCAT 01M09 (corr MV). Looking att the common version PR 2019 that we got a little while ago we noticed that DGPROP 01X99 'Other disorders of the nervous system' and MDC 01 'Other disorders of the nervous system' are also missing so we included those too.

#8 Updated by Mats Fernström 4 months ago

Mats Fernström, NPK Sweden 2019-03-05 (Swe ID C730)
I agree with Ralph that the decision from 2018-03-13 was not completely implemented in version 2019, neither in the NCC nor in the SoS version so the case must be reactivated. But Ralph happened to have a misprint. The decision was that DGCAT 01M99 is changed to 01M09 for the code pair G9480_B5000. Technical changes for version 2020 is attached in the file TC#565_C730 2019-03-05.xlsx_.

#9 Updated by Martti Virtanen 3 months ago

2019-03-11 Expert group
Expert group noted the last corrections and accepted them.

In the technical changes Technical changes case #565-2.xlsx there was a proposal to change B5000 'Plasmodium falciparum malaria with cerebral complications' form Dckat 01M99 to 01M09. However, neither this nor the addittion of 01M09 to code pair G4980*B5000 has been performed. The property 01M99 shall be added to the pair, other changes are not needed.

01X99 and MDC 01 are automatically added properties that are not visible in FoxPro based NDMS. It will be visible in the new NDMS.

I corrected the Technical changes accordingly.

#10 Updated by Martti Virtanen 3 months ago

  • Status changed from Re-activated to Accepted

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