Case #379

Updated by Martti Virtanen almost 5 years ago

National ID: CPK ID C446
Initiated: 2014-12-09
Initiator: Ralph Dahlgren, The Swedish National Board of Health and Welfare

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Problem
Addition of a procedure code for certificate writing, for example GD003 Intyg, omfattande (Certificate, extensive) or XS013 Avstämningsmöte med försäkringskassan (Status meeting with the social insurance) leads to an administrative DRG-group, X63O/926V X63O Vårdadministrativa åtgärder, öppenvård (Administration of care, short therapy) (Healthcare Administrative procedures, outpatient) which has a lower weight (and possibly lower reimbursement) than many visits without the procedure codes, and many clinics may therefore skip the reporting of these procedure codes.

Analysis
In general terms, addition of a procedure code should not lower the weight of a DRG group in Nord-DRG. We do not want to diminish the reporting to our health registers.
As for now the grouping property that goes to DRG X63O/926V X63O is procpro 40V39. The following codes have that property:

!40V39.jpg!


AV097 Smittspårning
DV093 Upprättande av rehabiliteringsplan
GD001 Anmälan enligt lag
GD003 Intyg, omfattande
GD004 Övriga anmälningar
GD005 Vårdintyg
GD007 Anmälan för utredning enligt LVM
GD008 Anmälan enligt SoL angående barn med möjligt skyddsbehov
XS004 Distanskonsultation
XS013 Avstämningsmöte med försäkringskassan
The Swedish Expert group (SWEX) wants the cases that group to DRG X63O/926V X63O also should have the proper ICD-10 code. After consulting with KLT at the Swedish National Board of Health and Welfare it has been established that one of the following codes should be the main diagnosis:

!Z0270.jpg!


Z027 Utfärdande av vissa medicinska intyg
Z027A Utfärdande av dödsbevis
Z027B Utfärdande av friskintyg
Z027C Utfördande av dödsorsaksintyg.
It is then required that the ICD-codes mentioned before get a new property that leads to DRG X63O/926V. X63O. The suggestion is to give these codes a new PDGPRO 23P05 Issue of certificate.


Suggestion
Technical change
Add new
Changes in ICD-code properties mentioned before, adding of PDGPROP 23P05 'Issue Issue of certificate to the codes': codes: Z027, Z027A, Z027B, Z027C.
Change Also change of the rule row for DRG X63O/926V X63O in DRGlogic and there add 23P05 in the pdgprop column.
Decided changes
DRG change
Should not be so much difference, some of the present cases in DRG X63O might be grouped to more diagnose specific DRGs.


Technical change
Se Excell file: Technical changes, Decision NPK C446

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