Case #784

New codes for surgical aftercare

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

Status:AcceptedStart date:2021-09-02
Priority:MinorSpent time:-
Target version:Target version 2022
Initiator:Sweden Target year:2022
MDC:GEN Owner / responsible:National organisations
Target Grouper:SWE Old forum status:


This case concerns only Sweden and is done due to the fact that sweden forgott to include some information in the primary file for Swedish updates.
The centre made a very correct suggestion that a new case should be done for sake of transparency.
Sweden has gotten two new ICD-10 codes concerning surgical aftercare. These new codes, five position, are more specific than than the previous code we have for surgical aftercare.
Z488A Annan specificerad kirurgisk eftervård vid sjukdom i cirkulationsorganen
Z488W Annan specificerad kirurgisk eftervård vid sjukdom med ospecificerad lokalisation
The two codes will have different grouping properties, seen in included file.
Z448A will get a new DGCAT 05M20 Aftercare for cardiovascular diseases.
This also means that Sweden has to include two new rows in DRG logic for incare. We already have a DRG for these patients but are now adding a new way to be grouped to our DRG W21E/C Eftervård vid kardiovaskulär sjukdom, ej komplicerat/komplicerat (Aftercare for cardiovascular disease not complicated/complicated).
The positioning of these two rows are shown in the TC.

C902 New codes for aftercare TC 2021-09-02.xlsx (20.9 KB) Ralph Dahlgren, 2021-09-02 16:30

TC_784_NDMS_13092021.xlsx (21.6 KB) Kristiina Kahur, 2021-09-13 10:12


#1 Updated by Kristiina Kahur about 1 month ago

Nordic Casemix Centre/Kristiina Kahur 7-9-2021

This changes was done in NDMS/MBC.
For national code Z488A a new icd+ codes was created (Z488A Other specified surgical follow-up care for circulatory organs).
National code Z488W is mapped to existing icd+ code Z4880 Other specified surgical follow-up care and this way gets the features given to plus code Z4880 as follows:
DGCAT 23M03 Aftercare
MDC 23 Factors influencing health status and other contacts with health services

New DGCAT 05M20 Aftercare for cardiovascular diseases was created for SWE version. All the properties were added to Z488A as suggested in the TC.
TCs exported from NDMS are attached.

I also made two testcases to check if the grouping result is correct.
1) The main dg Z488A, duration 3 days, age 20000 days, code E117 as secondary diagnosis
2) The main dg Z488A, duration 3 days, age 20000 days, no secondary diagnosis
The grouping results were as follows:
1) E69C (rule id 405D440005) Andra cirkulationssjukdomar, komplicerat
2) E69E (rule id 405D441000) Andra cirkulationssjukdomar, ej komplicerat
Both rules are higher in the hierarchy compared to new rules.

Are the new rules in correct place in the hierarchy or is there something wrong with testcase?

#2 Updated by Ralph Dahlgren about 1 month ago

2021-09-08 Ralph D
Thank you so very much for pointing out that the original suggested placing is not correct.
This shows the importance of makeing test case, if we had done that we would have found out whqat you did.
As you show we have to move the two rows above the Swedish DRG E69E (rule id 405D44100), E69C (rule id 405D440005), E69A (rule id 405D4400001). Preferebly below our DRG E53E (Hypertension, not komplicated with rule id 40530009.
If looking att ord values the two rows should be placed bettween ord 70504300090 and 7050440000. This is in the las commonversion that I have.
But you are welcom to change the ord walues to the one the comes out in NDMS. If you have to change rule id you can do that too.
Please just tell us so we can use it.

#3 Updated by Kristiina Kahur about 1 month ago

Nordic Casemix Centre/Kristiina Kahur 13-9-2021

Thanks for clarifications. The hierachy is corrected in NDMS and new two rules are placed between swe rules with id 405D430009 (E53E Hypertoni, ej komplicerat) and 405D4400001 (E69A Andra cirkulationssjukdomar, mycket komplicerat). As the ord values are generated automatically in NDMS taking into account all natinoal versions' rows, they might differ from the ord values in SoS version. Row id values remained the same and are identical in NDMS and SoS and should be used for reference.
All changes regarding this case made in NDMS can be seen in attached TC.
I also checked the test case (using the same variables as indicated previously) and got the correct results (see attached file, sheet 'testcase').
The case is closed.

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