Case #590

Prefabricated orthosis and the handmade orthosis, DRG 808Y and 908O

Added by Hanne Osnes-Ringen over 2 years ago. Updated 2 months ago.

Status:AcceptedStart date:2018-02-23
Priority:MinorSpent time:-
Assignee:Hanne Osnes-Ringen
Category:-
Target version:Target version 2019
Initiator:Norway Target year:2019
Case type:Minor Owner / responsible:
MDC:MDC08 Old forum status:
Target Grouper:NOR

Description

The prefabricated orthosis and the handmade orthosis sort to different DRGs. The prefabricated orthosis (NDX31) sort to DRG 908O however the handmade orthosis (NDX32) sort to DRG 808Y. We would like the orthosis to be grouped together. We therefore suggest the orthosis (both handmade and prefabricated) to group to DRG 808Y orthopedic bandaging.

Technical changes case_590.xls (103 KB) Anja Fagervold, 2018-02-27 11:59

Technical changes case #590.xlsx (35.8 KB) Martti Virtanen, 2018-03-07 15:55

History

#2 Updated by Ralph Dahlgren over 2 years ago

2018-02-28 Ralph Dahlgren
Norway are so welcome to do this, looking at common we think we understand why. Sweden do not want this change.

#3 Updated by Kristiina Kahur over 2 years ago

Finnish National DRG-Centre 6-3-2018

According to NCSP+ mapping the respective codes in Finland are TND31 and TND32. 52% of the cases with TND31 or TND32 group to DRG 908O, 11% to DRG 808O, rest of the cases (37%) to 50 different DRGs.
The grouping into different DRGs has been infulenced by use of some other codes, not TND31 or TND32. Both codes, TND31 and TND32 have the same PROCPR 08X14 'Problem of the hand' in Finnish version and don't influence the grouoing.
From cost point of view the cases with TND31 and TND32 are somewhere between DRGs 808O and 908O. We wouldn't take any action right now to change the grouping logic.

#4 Updated by Martti Virtanen over 2 years ago

  • File Technical changes case #590.xlsx added

2018-03-07 Martti Virtanen

This proposal only affects Nor and Ice versions since the other version do not use the property 08O20.
The change is minor, but one should consider in all countries similar interventions. They are listed in the techincal changes document.

#5 Updated by Martti Virtanen over 2 years ago

  • File deleted (Technical changes case #590.xlsx)

#7 Updated by Martti Virtanen over 1 year ago

  • Status changed from Active to Accepted

2018-03-13 Expert group
Expert group accepted the proposed change.

#8 Updated by Birna Björg Másdóttir 10 months ago

Following the 2018 spring meeting, Iceland wished for this change to apply to its groupper but it has not yet been included. So we reiterate that we would like this change to apply to the Icelandic groupper, preferably the 2020 groupper, if possible.

#9 Updated by Kristiina Kahur 10 months ago

Nordic Casemix Centre/Kristiina Kahur 10-9-2019

This change has been implemented according to the technical changes attached to the ticket. It means that procedure code NDXX31 was given PROCPRO 08O20, which takes all cases with NDXX31 to DRG 808Y in ICE version (also in NOR version).

#10 Updated by Anja Fagervold 5 months ago

Norway will also implement this change for the other procedurecodes for prefabricated orthosis. This means that also the codes NAX31, NBX31, NCX31, NEC31, NFX31, NGX31 and NHX31 are given PROCPRO 08O20 and will sort to DRG 808Y.

#11 Updated by Kristiina Kahur 4 months ago

Nordic Casemix Centre/Kristiina Kahur 19-3-2020

This case was discussed during the March meeting but we decided to get back to this later during the meeting which we did not have time anymore.
Therefore it needs some more clarification.

Given that PROCPR 08O20 is used in Iceland and Norway, then adding it to following procedure codes (see below) needs the acceptance by Iceland:

NAX31/NAXX31
NBX31/NBXX31
NCX31/NCXX31
NFX31/NFXX31
NGX31/NGXX31
NHX31/NHXX31

Given the earlier positive feedback from Iceland about the original change, we assume that Iceland also accepts the updated change made by Norway. However, we would like to get confirmation from Iceland at your earliest convenience.

For information to Norway, code NEC31 is not in NDMS at the moment and need to be added along the update of basic classification.

#12 Updated by Birna Björg Másdóttir 2 months ago

Iceland accepts the updated change

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