Case #251

Updated by Martti Virtanen about 5 years ago

National ID: NPK ID 535
Initiated: 2013-11-13
Initiator: NPK, Sweden

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*Problem*

_The Swedish National Board of Health and Welfare (SOS) makes own definition tables parallel to the process at the Nordic Casemix Centre (NCC) and the current problem was discovered during routine comparison between SWE2014CC-SOS-PR02 (SOS version) and SWE2014PR0F (NCC version) in the autumn 2013._

The J37 diagnosis codes (Chronic laryngitis and laryngotracheitis) have had DGCAT 03M05 for at least 10 years in the Swedish versions of NordDRG. Late in the updating process for version 2014 Martti wanted to change DGCAT to 03M08 for the J370 codes (including the Swedish subcodes) with the motivation that it was an “adjustment between the Nordic versions, must be the same in all versions”. We did not accept the change in the SOS version.

We agree that the codes should have the same DGCAT in all versions but it has never been discussed weather 03M05 or 03M08 is the best property.

*Analysis*

DGCAT 03M05 leads to DRG C35 (DRG 70 in Common) with the text “Otitis media and upper respiratory infections” and DGCAT 03M08 leads to DRG C48/C49 (DRG 73/74 in Common) with the text “Other ear, nose, mouth & throat diagnoses”. In a medical descriptive perspective we think that DRG C35/70 is a better alternative, especially since DRG C48/C49/73/74 are heterogeneous rest groups.
We have done an economic analysis (see table below).

!2014-CPK-ID-535.jpg!

According to this the mean cost for the J37 cases is somewhat closer to the mean cost for all DRG C35E than for the mean costs for DRG C48/C49.
Thus we think that DRG C35/70 is a better alternative for the J37 cases, also in an economic perspective and therefore DGCAT 03M05 is better than 03M08 for the J370 codes.

*Suggestion*

*NPK, Sweden – 2014-01-29*

Based on the analysis above we suggest that the DGCAT value is changed from 03M08 to 03M05 in all versions of NordDRG. See +Suggestion NPK ID 535+.

*Decided changes*

*Organization – yyyy-mm-dd*

National organizations may decide to introduce the change in their own version.
Otherwise the organization is NCC.

*DRG change*

Cases with a principal diagnosis code beginning with J370 will be grouped to DRG C35 (DRG 70 in Common) instead of DRG C48/C49 (DRG 73/74 in Common).

*Technical change*

Technical description in text format.
There must also be technical changes according to the NCC Excel template. This Excel file should be named “Decision” plus the ID of the case.

*Introduction*

NordDRG [year] [version]

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