Case #613

Interventions with 09S07 'Other skin, subcutaneous tissue or breast procedure' without OR=1

Added by Martti Virtanen 6 months ago. Updated about 1 month ago.

Status:Further activeStart date:2018-12-11
Priority:MinorSpent time:-
Assignee:-
Category:-
Target version:NordDRG 2020
Initiator:Nordic Casemix Centre Target year:2020
Case type: Owner / responsible:
MDC:MDC09 Old forum status:
Target Grouper:COMMON, DEN, EST, FIN, ICE, LAT, NOR, SWE

Description

In the Case #540 it was detected that there is a large number of interventions with the property 09S07 'Other skin, subcutaneous tissue or breast procedure' that do not have OR=1 property. The property 09S07 is meant to be interventions with OR=1 and corresponding less demanding properties that do not demand operation room circumstances should have the property 09S08 'Other skin, subcutaneous tissue or breast procedure, not OR procedure'

The reason is that these interventions have had OR=1 but they have been changed to have OR=2 or even OR=0. However, the 09S07 has not been changed to 09S08 as it should

It was discussed at the expert group that these interventions must be changed to 09S08. This is not only logical, but it may even result in wrong DRG assignment and may demand extra rules in the logic.

The technical changes lists the affected codes based on Swedish proposal in Case #540. It is possible that not all affected NCSP+ codes are included since some may be without corresponding Swedish code.
In the logic the rule with 09S07 and 00X10 (anaesthesia) should become unnecessary.

This is in pricipal technical change without effect on DRG assignment.

Technical changes case #613.xlsx (85.8 KB) Martti Virtanen, 2018-12-11 14:28

History

#1 Updated by Martti Virtanen 6 months ago

#2 Updated by Martti Virtanen 6 months ago

  • Description updated (diff)

#3 Updated by Martti Virtanen 6 months ago

  • Target version set to NordDRG 2020

#4 Updated by Kristiina Kahur 4 months ago

Finnish National DRG-Centre 2019-2-13

In addition to codes presented in appendix “Technical changes case #613.xlsx”, in Finnish version following codes have PROCPR 09S07 and OR=2 which should be corrected:
QXE10/QXSE80 Excision of other lesion extending through all layers of skin in unspecified region
QXE15/QXSE82 Excision of other superficial lesion of skin in unspecified region
QXE99/QXSE99 Other excision or repair of unspecified region of skin
TQW00/QXSE82 Excision of other superficial lesion of skin in unspecified region
TQW02/QXSE80 Excision of other lesion extending through all layers of skin in unspecified region

#5 Updated by Ralph Dahlgren 4 months ago

2019-02-23 Ralph Dahlgren
Sweden has controlled our procedure codes and we think they are correct. We do not need any addition. We do not have the Finnish codes that has to be corrected. But we do have TQW99 Annat mindre ingrepp på hud eller subkutan vävnad that has OR2 but not procpro 09S07. But we think this is alright.

#6 Updated by Martti Virtanen 3 months ago

2019-03-11 Expert group
The principle was accepted. If in futre this kind of problems appear, this principle will be followed.

#7 Updated by Martti Virtanen 3 months ago

  • Status changed from Active to Accepted

#8 Updated by Martti Virtanen about 1 month ago

  • Status changed from Accepted to Further active

2019-05-08 Nordic Casemix Centre/Martti Virtanen
It is truth that none of the codes used Sweden has this problem However, the codes listed Finland (Kristiina Kahur) need to be corrected.
Since at least QXSE99 is in use in all countries except Sweden we will discuss the issue at expert group in spring 2020.

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