Case #608

Codes with identical content must have same properties

Added by Martti Virtanen 8 months ago. Updated 4 months ago.

Status:AcceptedStart date:2018-11-28
Priority:MinorSpent time:-
Target version:-
Initiator:Nordic Casemix Centre Target year:2020
Case type:Minor Owner / responsible:
MDC: Old forum status:
Target Grouper:


There are several situations in the national versions of ICD and NCSP where codes have identical content. Especially the Swedish national subcodes in ICD-10 that end with ‘W’ have exactly the same wording as the original code that is still valid (see for example B378 and B378W).
It is obvious that these codes must have same properties to be assigned identically in NordDRG.
When/because they are also linked together it is even technically impossible to give different properties
This is valid also for any pairs where in two pairs one of the parts are codes with identical content (for example K238*B378 and K238*B378W).

Koll C785.xlsx (169 KB) Mats Fernström, 2019-03-21 16:11


#1 Updated by Martti Virtanen 7 months ago

  • Target version deleted (Target version 2019)
  • Target year 2020 added

#2 Updated by Ralph Dahlgren 5 months ago

2019-02-23 Ralph Dahlgren
There are in some cases in Sweden two ways of coding the same disease in ICD-10. This is one of the cases.
This happens since Sweden has created ICD-10 codes on a ’five’ position level. These ’five’ position’ codes are usually more specified than the ’four position ’ code.
But not in this case.
In this case Sweden has created a ’five position’ code for candidaesophagitis’. The code is ’B37.8D Candidaesofagit’. The code was created to provide an opportunity to use one code for a rather common disease, candidaesophagitis. There is only one problem with this and that concerns the Swedish coding rules. All Swedish ’five position’ codes are "voluntary" to use. This means that they are not used consistently all over the country.
Then we also have the asterisk-dagger combination K23.8 * B37.8 † for ’Candidaesofagit’ (candidaesophagitis).
So in Sweden we havet these two ways to code the same disease.
Not very practical but it is reality.
The DRG-team has controlled with our collegues on the Classification and Terminology that both way of coding is correct and can be used.
So for this reasen and also out of a very practical way we want to keep both ways so we have a reminder of the fact that there is two ways of coding this disease.
This means that we cannot agree to Marttis suggestion.

#3 Updated by Martti Virtanen 4 months ago

2019-03-04 NCC (MV)
The general principle holds and it is technically impossible to have different properties for to identical codes.
The case #606 deals with the same matter and I stated there:
'The only way around this problem seems to be that B378D is maintained as separate code (only used by Sweden) in ICD+ that causes some maintenance problems if the properties of the codes change. It also creates unnecessary repeating in the classification (braking in principle the structure of the classification)'

As one can see, I see this as an error in the classification maintenance, but If Sweden must have that way, we can do by adding the B378D in ICD+.

#4 Updated by Mats Fernström 4 months ago

Mats Fernström, NPK Sweden 2019-03-21 (Swe ID C785)
We have now compared all subcodes ending with W with the corresponding original codes in the SOS version for 2019 and all of them have the same properties. See the file Koll C785.xlsx.

#5 Updated by Martti Virtanen 4 months ago

  • Status changed from Active to Accepted

2019-03-11 Expert group
The principle was accepted but the special case of K2380*B3780 has be dealt with separately (see Case #606)

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