Case #256

Updated by Martti Virtanen over 7 years ago

National ID: CPK ID 540
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._

During the updating process for NordDRG 2014 we noticed that the procedure codes for peripheral vein occlusion differ concerning the properties 14S90 and 21S09 in the NCC and SOS versions. (In the tables below also central vein occlusion, PHT23-PHT32, is included but only for comparison with procedures on peripheral veins.)

!2014-CPK-ID-540_1.jpg!

!2014-CPK-ID-540_2.jpg!

*Analysis*

The codes PHT99 and PHV99 are somewhat problematic since they theoretically can stand for both central and peripheral procedures. In practice, however, they are most probably used only for peripheral occlusions.

+Concerning 14S90 (Significant operation for obstetrical patient)+:

The only function of procedure property 14S90 is that its presence will prevent a patient case from being grouped to the DRGs for vaginal delivery and the case will instead be grouped to other DRGs, depending on diagnoses and other procedure properties. The purpose of this logic is that a procedure that is greater than vaginal delivery shall decide the grouping if the procedure is performed during the stay for delivery. We think that peripheral vein occlusions are not greater than vaginal delivery so 14S90 should be removed from all these codes. Thus, 14S90 should be removed from PHT15, PHV13, PHV14, PHV99 and TPH10 in the NCC version and from PHT15 and PHV99 in the SOS version.

+Concerning 21S09 (Other OR procedure for injuries)+:

The procedure property 21S09 is only involved in the rules for the trauma DRGs U19/443 (Andra operationer el. åtgärder i större anestesi efter skada), U51O/486O (Reimplantation och andra op vid multipelt trauma, öppenvård) and U59N/486 (Övriga operationer vid multipelt trauma) and peripheral vein occlusions are not relevant in these trauma cases. In the Swedish KPP database for 2011 we had only one case with peripheral vein occlusion (PHT99) out of total 1385 cases in these DRGs. Thus, 21S09 can be removed from PHT10, PHT15, PHT99, PHV10, PHV13, PHV14, PHV99 and TPH10 in the NCC version and from PHT10, PHT15 and PHT99 in the SOS version.

*Suggestion*

*NPK, Sweden – 2014-02-06*

14S90 is removed from PHT15, PHV13, PHV14, PHV99 and TPH10 in the NCC version and from PHT15 and PHV99 in the SOS version.
21S09 is removed from PHT10, PHT15, PHT99, PHV10, PHV13, PHV14, PHV99 and TPH10 in the NCC version and from PHT10, PHT15 and PHT99 in the SOS version.

The changes are also specified in +Suggestion CPK ID 540.xls+.

*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*

The removal of 14S90 will cause a minor transfer of patients from a surgical DRG to a DRG for vaginal delivery. The removal of 21S09 will have a negligible effect.

*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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