Case #408

Updated by Martti Virtanen almost 5 years ago

National ID: HD-0109
Initiated: 2015-02-25
Initiator: Norwegian Directorate of Health
Responsible at National organization: Kristin Dahlen
Sent to NordDRG Forum: 2015-02-25
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*Problem* Problem
We observe some inconsistency in the DRG logic for newborns with respiratory problems, as can be seen in the table.


!HD-0109-1.jpg!


Babies between 8 and 29 days old coded with P2850 'Respiratory failure of newborn' P28.5 “respirasjonssvikt hos nyfødt” without anh procedures the procedure code are assigned to gives DRG 385B/Q10N 'Follow-up 385B “follow-up care of neonatal problems or delayed neonatal problem, birth weight over 1000 g or more'. g”.

If procedure WAA728/GXAV10 'Continuous positive airway pressure therapy (CPAP)' code GXAV10 “behandling med kontinuerlig positivt luftveistrykk” is perorformed, used, the case DRG will assingned change to DRG 390/Q55N 'Neonate, 390 “Neonate, birthweight 2500 g or more, with other significant problem'. problem”.

This does not make sense, and can lead to a problem with reporting WAA728/GXAV10. the GXAV10-code.

WAA728/GXAV10 has the procedure property 15S02 'Neonatal GXAV10 is classified as a neonatal intensive care procedure'. procedure (PROCPR 15S02).

Analysis
Norwegian directorate of health
The problem seems to be the rule 015D8011. Be aware that the table presented here only shows part of the logic.
!HD-0109-2.jpg!

*Analysis*
Norwegian directorate of health
No economical analysis available.

*Suggestion*

Suggestion
Norwegian directorate of health – 2015-02-25


We suggest to move the rule 015D8011 below rule 015D08221 (DRG 388B). Accordingly we suggest to remove the secproc -15S02 from rule 015D8011.

The rule 015D80109 can then be deleted.

Decided changes
Organization – yyyy-mm-dd

DRG change

Technical change

Introduction:
NordDRG [year] [version]

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