Case #594

Updates concerning Swedish NordDRG 2019 PR version

Added by Ralph Dahlgren 8 months ago. Updated about 1 month ago.

Status:AcceptedStart date:2018-08-16
Priority:MinorSpent time:-
Target version:-
Initiator:Sweden Target year:2019
Case type:Minor Owner / responsible:
MDC:GEN Old forum status:
Target Grouper:SWE


This is the Swedish updates concerning the Swedish 2019 NordDRG PR version.
Updates are a few in DRGlogic, new ICD-10 and procedure codes. Also update in DRG names.
Sweden has updated the ATC-codes. At the same time where it has been possible changed to Swedish drug/medicine names, also added some ATC-codes that has not been in the system Before (veterinarian drugs/medicines).

Uppdateringar för 2019, ICD, KVÅ, DRG, 20180816.xlsx (296 KB) Ralph Dahlgren, 2018-08-16 11:30

Technical changes case #594.xlsx (312 KB) Martti Virtanen, 2018-08-22 12:08


#1 Updated by Martti Virtanen 8 months ago

2018-08-22 Martti Virtanen
The Swedish ICD and intervention codes have now been imported to ICD+ and NCSP+.
There were a few questions about the linkage of the new codes which may at a few places have some effect on properties.

The sheets about changes to properties (dg0,dg1,proc0,proc1 and komples) cannot be used in NordDRG because the properties are defined to the ICD+ and NCSP+ codes and will only secondarily change the properties of the national codes. However, we will check if the wished properties will appear on national level and if possible adjust the common level properties.

The typing error of dgcat 07M04 shall be corrected.

The changes in logic do not belong to this case and thefore neither the changes to DRG-names.
They will be moved to a new case.

The ATC-classification is an external add on to the basic classifications. Due to the fact that it is not properly maintained for the Nordic countries, it is currently available only in English version that is very old. We have only added codes that can affect NordDRG. Codes that do not affect NordDRG are listed in DG0-sheet which indicates that it does not matter in DRG-assignment whether they are registered or not for the patients.
Currently we cannot deliver national language text for these codes and there is no reason to update these codes with the exception of new codes that must have properties affecting NordDRG.

#2 Updated by Ralph Dahlgren 7 months ago

2018-09-23 Ralph Dahlgren
During the last Expert Meeting Martti asked Sweden to communicate about one code that we did not agree on the Mapping. It was the ICD-10 code T769 Ospecificerad effekt av yttre orsak. T769 is a new WHO-code that Sweden wanted to be given the same grouping properties as T758.
MArtti suggested it to be mapped to Z0430.
Sweden does not want this.
All other T-codes is mapped to T-codes in ICD+. Sweden wants to continue this principle at least for now.
So the new WHO code T769 Sweden wants to get in the Swedish Definitiontables the same properties as T758. They are as follows:
DGCAT 21M99 Other injury, poisoning and toxic effects diagnoses
MDC 21 Injuries, poisonings and toxic effects of drugs
DGPROP 21X99 Injuries, poisonings and toxic effects of drugs
DGPROP 15X98 Other significant problem of neonate

#3 Updated by Kristin Dahlen 7 months ago

The Norwegian version have the same new code called T76 'Unspecified effects of external causes'(Uspesifiserte virkninger av ytre årsaker). As specified earlier the properties we want is common to the ones specified by Ralph.

#4 Updated by Kristiina Kahur 7 months ago

Finnish National DRG-Centre 2018-9-22

Just for the records, in Finnish version there is no such code as T76 and there is no need for changes.

#5 Updated by Mats Fernström 6 months ago

Mats Fernström, NPK Sweden 2018-10-31 (Swe ID C721)
Now, late in the process, we have noticed errors in the file with Swedish primary code updates, Uppdateringar för 2019, ICD, KVÅ, DRG, 20180816.xlsx. As a consequence, the errors are also present in Marttis file Technical changes case #594.xlsx. The errors are about the Swedish procedure codes DF031 and DF032.
DF031 was reported as a new code with the text “Avlägsnande av elektrokardiograf med loop recorder” which is wrong in a double sense. DF031 is not a new code (it exists since 2009) and the reported text is also wrong. The correct text is "Avläsning av EKG-från loop-registrering".
DF032 is the new code for 2019 with the text "Avlägsnande av elektrokardiograf med loop recorder" and that code was unfortunately missing in our update file and therefore it was also missing in Marttis file for technical changes.
We were misled by the reported erroneous text for DF031 and gave it wrong properties. The properties we suggested for DF031 shall instead be applied to DF032, which is comparable to QBC00/QBSC00 ‘Avlägsnande av subkutan främmande kropp på bål’.
What about the properties for DF031 then? That code has had no properties at all in the Swedish version, which is wrong as well. It must have the same properties as AF024/FXF000 ‘Elektrokardiografi (EKG), 12 avledningar, standard, tolkning (i)’.
In summary, this means that:
DF031 ’Avläsning av EKG-från loop-registrering’ is mapped to FXF000 and shall have PROCPR 40V39 and no other properties in the Swedish version.
DF032 ‘Avlägsnande av elektrokardiograf med loop recorder’ is mapped to QBSC00 and shall have the following properties in the Swedish version:
OR 2

#6 Updated by Martti Virtanen about 1 month ago

2019-02-27 NCC
This seems to be a small misstake somewhere.

DF031 is linked to FXF022 'Analysis of loop recorder data of cardiac arythmias' that has the properties 40V39 and 05O22. O5O22 is not used in NordDRG Swe (Not linked to FXF000 that has no properties)

I have now added DF032 'Removal of electrocardigrafic device with loop recorder'. It is good to note that NCSP+ already has a code FXF024 'Removal of Loop Recorder' which I think is the same intervention. However this code has no propertis. (It is included in Danish and Icelandic CSP versions)
The linkage QBSC00 'Removal of foreign body from skin or subcutaneous tissue of trunk' is an interesting idea. Obviously this a foreign body that is implanted under the skin of chest. However, it is not a skin intervention (09S08 'Other skin, subcutaneous tissue or breast procedure, not OR procedure' or 09V05 'Minor dermatologic intervention') neither a trauma related intervention (21S09 'Other OR procedure for injuries') or mammary gland related intervention (30S99 'Other breast procedure'). The propety OR=2 has anyway no effect in Sweden.

I think we should link DF032 to FXF024 without any properties.

#7 Updated by Mats Fernström about 1 month ago

Mats Fernström, NPK Sweden 2019-03-05 (Swe ID C721)
FXF000 used to have PROCPR 40V39 but I missed that it has been changed. Obviously it is important to check the column “Valid” in the table PROC. Anyhow, the mapping of DF031 to FXF022 is fine, both semantically and with respect to grouping properties.
DF032 is partly a procedure on skin and subcutaneous tissue but it is of course not a procedure for skin disease so I understand that Martti does not like the mapping to QBSC00. The mapping to FXF024 is fine semantically but the question is if FXF024 should have some properties. Since DF032/FXF024 is a new code in Sweden we don’t have any cost (KPP) data so it would be good if Denmark or Iceland, that have used the code for some time, could provide cost data. Otherwise, after looking at a video showing insertion of a loop recorder, I am inclined to agree with Martti that there is no need for a grouping property. It is really a tiny procedure performed in an outpatient department. Without properties for DF032/FXF024 the cases in Sweden will be grouped to DRG E65O ‘Läkarbesök vid hjärtarytmier och överledningsstörningar’ with the weight 0,069, which corresponds to the cost 3 918 SEK, and it may be quite OK, but we will await any cost data from Denmark and Iceland, as well as any comments from the other countries on the upcoming expert meeting, before making a decision.

#8 Updated by Martti Virtanen about 1 month ago

  • Status changed from Active to Accepted

2019-03-11 Expert group
Expert group accepted that DF032 is linked to FXF024 that will currently not have any properties (i.e. only OR=0)
Othewise the case is already executed.

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