Case #626

Integrating ICPC2 codes into NordDRG system

Added by Kristiina Kahur over 1 year ago. Updated 7 months ago.

Status:RejectedStart date:2019-02-08
Priority:NormalSpent time:-
Assignee:Kristiina Kahur
Target version:-
Initiator:Finland Target year:2020
Case type: Owner / responsible:National organisations
MDC:GEN Old forum status:
Target Grouper:FIN


ICPC2 (International Classification of Primary Care, Second edition) codes are currently not part of the NordDRG system, and cases with ICPC2 codes are assigned into error DRGs (470E Main diagnosis invalid and 470U Main diagnosis invalid, short therapy).
However, in Finland, the codes are used (often in ER by nurses) and should be taken into account also in the assignment process.
Technically it should be possible by adding ICPC2 into primary classification and mapping the ICPC2 codes with ICD+ ones so that the properties of respective ICD+ codes would be given also to ICPC2 codes.
We would like to have preliminary discussion in March meeting and after that submit the tables where ICPC2 codes are mapped with ICD+ codes.

ENG_icpc-2e-v7.0.xlsx - Appendix 1 (126 KB) Kristiina Kahur, 2019-02-25 11:37


#1 Updated by Kristiina Kahur over 1 year ago

  • Target year 2020 added

#2 Updated by Ralph Dahlgren over 1 year ago

2019-02-23 Ralph Dahlgren
It would be interesting to know how Findland would incorporate this in their DRG system before the meeting. It is then easier to understand the idea behind. Because as I understand it is used in the ER by nurses, isn't doctors in the ER also seeing the same patient?
On WHO webb-page it says as follows:
'WHO has accepted ICPC-2 within the WHO FIC mainly as a reason for encounter classification, and users may use it as a classification for primary care or general practice wherever applicable.
ICPC-2 classifies patient data and clinical activity in the domains of General/Family Practice and primary care, taking into account the frequency distribution of problems seen in these domains. It allows classification of the patient’s reason for encounter (RFE), the problems/diagnosis managed, interventions, and the ordering of these data in an episode of care structure
Classification Structure
It has a biaxial structure and consists of 17 chapters, each divided into 7 components dealing with symptoms and complaints (comp. 1), diagnostic, screening and preventive procedures (comp. 2), medication, treatment and procedures (comp. 3), test results (comp. 4), administrative (comp. 5), referrals and other reasons for encounter (comp. 6) and diseases (comp. 7).'
It is an interesting idea but ICPC2 contains quite alot of codes.
Is it not possible for nurses to use ICD-10 codes instead?
If this big amount of mapping is not done before it arrives to the Nordic Casemix Centre it will make alot of work for the centre. Is there enough time for this work now when also working with the NDMS?

#3 Updated by Kristiina Kahur over 1 year ago

Finnish National DRG-Centre 2019-2-25

The official/original mapping is provided in Appendix 1.
In column I (icd10), ICD10 codes corresponding to a ICPC2 code are listed (there can be more than one ICD10 code per ICPC2 code). The first one should be the one which is most relevant to respective ICPC2 code and should be used for mapping. In Finland, some modifications in mapping have been made. The mapping is publicly available.
Given that ICPC2 is much more robust classification compared to ICD10, the mapping is somehow conditional. Nevertheless, based on the mapping, each ICPC code should be given the same propertie(s) which have been given to respective ICD10 code and this way the ICPC2 codes can be taken into account in the grouping process.
As for seeing the patients in ER, it might be that the nurses only are seeing the patients and are using ICPC2 codes in that case.


#4 Updated by Martti Virtanen over 1 year ago

  • Status changed from Active to Further active

2019-03-11 Expert group
This work is currently only for Finland. We can integrate ICPC codes to ICD+ based on the existing mappings using the primary mapping ICPC-ICD.
The case is left open form possible further work in Finland.

#5 Updated by Martti Virtanen 7 months ago

  • Status changed from Further active to Rejected

2020-03-09 Expert group
The expert group was informed of the possibility to add ICPC-2 codes, that have a preferred linkage to ICD-10, to NDMS and NordDRG defintion tables.
Any change is on national level. If the ICPC-2 codes are added to the system, they will not appear as independent codes but only as linked national codes in the combined code list.
This case is closed without any changes to NDMS now (formally rejected).

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