Kristiina Kahur
Nordic Casemix Centre/Kristiina Kahur 2-3-2026
To facilitate the discussion, attached are all ESD (Endoscopic submucosal dissection), EMR (Endoscopic mucosal or submucosal resection) and colonoscopy codes and respective grouping features in all national versions.
Revision of existing grouping features of ESD codes and its impact on grouping should be supported by data (cost and clinical).
- Attachment #1001_925_ESD_EMR_grouping_features_2026PR1.xlsx added
Malle Avarsoo
I add some clinical and grouping details to discussion , which I have seen in EST version.
- The NCSP codes in table from Kristiina, valid for EST version, despite of several procpro-s , end up in conservative DRG-s , although they have also procpro 06S10 Other digestive system OR procedure.
-
JCSA45 Endoscopic mucosal or submucosal resection in oesophagus PROCPR 06S10 2 FALSE Other digestive system OR procedure est/swe/lat/ice/fin/nor JDSA45 Endoscopic mucosal or submucosal resection in stomach or pylorus PROCPR 06S10 2 FALSE Other digestive system OR procedure est/swe/lat/ice/fin/nor JDSH52 Endoscopic mucosal or submucosal resection in duodenum PROCPR 06S10 2 FALSE Other digestive system OR procedure est/swe/lat/ice/fin/nor With these NCSP codes EST version gives these DRG groups , which clinically seems not quite right, as ESD (Endoscopic submucosal dissection) and EMR (Endoscopic mucosal or submucosal resection) are both surgical interventions by endoscopic method.
-
Seedeelundite pahaloomulised kasvajad, kht-ga 172X Digestive malignancy, w CC Seedeelundite pahaloomulised kasvajad, kht-ta 173X Digestive malignancy, w/o CC Hope Kristiina can check my finding for EST version. Claims data confims this, cases with ESD or EMR group into conservative groups.
I suggest, that these cases which have the abovementioned NCSP codes should group into surgical DRG-s , as procpro 06S10 Other digestive system OR procedure , refers. Unfortunately I am not really able to post a technical change proposal, hope Kristiina and Lotta will give support in finding best solution.
Kristiina Kahur
Nordic Casemix Centre/Kristiina Kahur 5-3-2026
The reason why the cases with NCSP codes Malle referred to group to conservative DRGs is that all three codes have OR 2 value and if performed in inpatient settings without anesthesia or if with anesthesia but without coding it with a code with DGPROP 00X10 General anesthesia, the cases end up in a conservative DRG.
Anesthesia code would take the case into DRG 170 Other digestive system OR procedures, w CC or 171 Other digestive system OR procedures, w/o CC (if main dg is from MDC06).
All endoscopic mucosal or submucosal resection codes have OR 2 value with exception of code JGSA85 Endoscopic mucosal or submucosal resection in rectum in NOR version where the code has OR 1 value.
Kristiina Kahur
2026-03-10 Expert group
This case was discussed in EG meeting.
This case remains further active until countries have clinical and cost data to consider any further changes.
- Status changed from Active to Further active
Birna Björg Másdóttir
Iceland would like to make preliminary changes of DRG grouping for ESD treatment pending further analysis by the other countries. We would like outpatient cases to group into DRG 703O Endoscopic insertion of stent to gastrointestinal tract, short therapy. The Icelandic and Norwegian names include ablation also for this group.
Attached are TC.
Birna Björg Másdóttir
- Attachment TC_1001_ESD_ICE.xlsx added
Birna Björg Másdóttir
As we would like outpatients cases to still group into 153O or 171O if done in general anesthesia an additional rule for 171O has to be added. Attached are updated TC after help from Kristiina :-).
- Attachment TC_1001_ESD_ICE_updated.xlsx added
Kristiina Kahur
Nordic Casemix Centre/Kristiina Kahur 31-3-2026
The changes were done in ICE version as suggested. The final TCs are attached.
This case remains further active for countries to consider any changes related to ESD procedures.
- Attachment #1001_TC_ESD_ICE.xlsx added
Kristiina Kahur
Nordic Casemix Centre/Kristiina Kahur 13-4-2026
While double-checking the TCs, it turned out that there is no need to add a new rule for DRG 171O (id 106D1100002) in ICE version as there is an identical rule already (id 106D110010). Rule 106D1100002 will be removed from ICE version.
This case remains closed.