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<div class="journal-details-container"> <h4> Task #1001 has been updated by Malle Avarsoo. </h4> <div id="journal-5244-notes" class="note"><p> I add some clinical and grouping details to discussion , which I have seen in EST version. </p><ol> <li> 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. </li> <li> <figure class="table"><table><tbody> <tr> <td>JCSA45</td> <td>Endoscopic mucosal or submucosal resection in oesophagus</td> <td>PROCPR</td> <td>06S10</td> <td>2</td> <td>FALSE</td> <td>Other digestive system OR procedure</td> <td>est/swe/lat/ice/fin/nor</td> </tr> <tr> <td>JDSA45</td> <td>Endoscopic mucosal or submucosal resection in stomach or pylorus</td> <td>PROCPR</td> <td>06S10</td> <td>2</td> <td>FALSE</td> <td>Other digestive system OR procedure</td> <td>est/swe/lat/ice/fin/nor</td> </tr> <tr> <td>JDSH52</td> <td>Endoscopic mucosal or submucosal resection in duodenum</td> <td>PROCPR</td> <td>06S10</td> <td>2</td> <td>FALSE</td> <td>Other digestive system OR procedure</td> <td>est/swe/lat/ice/fin/nor</td> </tr> </tbody></table></figure><p>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. </p> </li> <li> <figure class="table"><table><tbody> <tr> <td>Seedeelundite pahaloomulised kasvajad, kht-ga</td> <td>172X</td> <td>Digestive malignancy, w CC</td> </tr> <tr> <td>Seedeelundite pahaloomulised kasvajad, kht-ta</td> <td>173X</td> <td>Digestive malignancy, w/o CC</td> </tr> </tbody></table></figure><p>Hope Kristiina can check my finding for EST version. Claims data confims this, cases with ESD or EMR group into conservative groups. </p> <p> 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. </p> </li> </ol></div></div> <hr/> <p>I would like to reopen the discussion of ESD treatment in gastrointestinal tract, that was discussed in case <span class="mention" data-mention="#925"><a class="issue tracker-3 status-5 priority-21 priority-default multieditable-container closed" title="Questions and answers: Endoscopic Submucosal Dissection (ESD) in colon (Closed)" href="https://nordcaseforum.easyredmine.com/issues/925">#925</a></span> . Now ESD treatment in colon is grouped the same way as regular colonoscopy, although ESD is considerably more time consuming, labor intensive and requires expensive equipment. Our gastroenterologists have brought this up again as the DRG grouping does not represent the treatment well. They have been in contact with Swedish and Norwegian colleagues who agree that change is needed. Therefore I would appreciate a discussion of the matter in the upcoming Expert meeting. I aim for having some cost analysis based on Icelandic data ready before the meeting.</p>
