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Task #1002 has been updated by Kristiina Kahur. Nordic Casemix Centre/Kristiina Kahur 5-3-2026This is to clarify that last year case #944 related to DRGs 361X/361O and 362X/362O was discussed. As a result, some changes were made in some of the PROCPR (see TC related to case #944) related to sterilization proc codes (starting with LGSA). In addition, the national text of those DRGs were corrected to clearly indicate that DRG 361 is for Gynecological laparoscopy and DRG 362 for Sterilization. Given that in Finnish version no changes were made, the names of those DRGs remained unchanged in FIN version as well as in COMB version. Therefore using COMB version names may by a bit misleading without the context.In your example, proc code JASL21 has PROCPR 13S08 Other female reproductive system OR procedure and proc code LBSD01 13S02 Uterine or adnexal procedure including intervention on embryo or ICSI (in swe/ice/fin version code has additional PROCPR 13S21 Excision or reconstructive operation on female reproductive organs) Combining those two procedures with main dg N809 and sec dg Z302, the case is assigned to DRG 359X Uterine and adnexa procedures for ovarian or adnexal non-malignancies, w/o CC or 359P Excision or reconstructive operation on female reproductive organs, short therapy, depending on length of stay. The reason for that is that the rule with the PROCPR 13S02 comes before the rule with PROCPR 13S08. Change of PROCPR 13S08 → 13S03 would not change the grouping because both PROCPRs come after 13S02 rules. However, as the NOR tables in NDMS are not identical with ones maintained by Helsedirektoratet, the grouping results may differ due to the differences in the tables. In some cases, female patients are referred for diagnostic laparoscopy, during which sterilization is performed at the same time. For example:Principal diagnosis:· N8090 – Endometriosis, unspecifiedSecondary diagnosis:· Z3020 – SterilizationProcedure codes:· JASL21 – Laparoscopic excision or destruction of lesion of the peritoneum· LBSD01 – Laparoscopic partial excision of the Fallopian tube any LGSA-code.Grouping (depending on length of stay):· DRG 362X – Laparoscopic or other endoscopic sterilization· DRG 362O – Laparoscopic or other endoscopic sterilization, short therapy In the Norwegian version (and other countries), there is a clear distinction between DRG 361X – Gynecological laparoscopy or sterilization via laparotomy / 361O – Gynecological laparoscopy or sterilization via laparotomy, short therapy and DRG 362X/362O, where DRG 361X/361O applies to laparoscopy and DRG 362X/362O applies to sterilization.In the example presented above, the main reason for the patient’s contact with the healthcare service is diagnostic laparoscopy. We therefore believe that the stay should group to DRG 361X/361O not DRG 362X/362O.We also have noted that certain relevant laparoscopy procedures should have the grouping property PROCPR 13S03 – Laparoscopy or incisional tubal interruption, but currently have PROCPR 13S08 – Other female reproductive system OR procedure. We therefore propose changing the grouping property from 13S08 to 13S03 for the following procedures:· JASL21 – Laparoscopic extirpation or destruction of lesion of the peritoneum· JASL24 – Laparoscopic excision of local lesion of the pelvic wall· JASL97 – Other laparoscopic local procedure of the peritoneumThis change would result in the example above grouping to DRG 361X/361O. See the attached TC. We would also like to discuss whether the names of DRG 361X/361O and DRG 362X/362O in the combined version should be revised to more clearly reflect this distinction. It appears that such a distinction already exists in a number of countries, based on the local DRG-names.
Nordic Casemix Centre/Kristiina Kahur 5-3-2026
This is to clarify that last year case #944 related to DRGs 361X/361O and 362X/362O was discussed. As a result, some changes were made in some of the PROCPR (see TC related to case #944) related to sterilization proc codes (starting with LGSA). In addition, the national text of those DRGs were corrected to clearly indicate that DRG 361 is for Gynecological laparoscopy and DRG 362 for Sterilization. Given that in Finnish version no changes were made, the names of those DRGs remained unchanged in FIN version as well as in COMB version. Therefore using COMB version names may by a bit misleading without the context.
In your example,
Combining those two procedures with main dg N809 and sec dg Z302, the case is assigned to DRG 359X Uterine and adnexa procedures for ovarian or adnexal non-malignancies, w/o CC or 359P Excision or reconstructive operation on female reproductive organs, short therapy, depending on length of stay. The reason for that is that the rule with the PROCPR 13S02 comes before the rule with PROCPR 13S08. Change of PROCPR 13S08 → 13S03 would not change the grouping because both PROCPRs come after 13S02 rules.
However, as the NOR tables in NDMS are not identical with ones maintained by Helsedirektoratet, the grouping results may differ due to the differences in the tables.
In some cases, female patients are referred for diagnostic laparoscopy, during which sterilization is performed at the same time. For example:
Principal diagnosis:
· N8090 – Endometriosis, unspecified
Secondary diagnosis:
· Z3020 – Sterilization
Procedure codes:
· JASL21 – Laparoscopic excision or destruction of lesion of the peritoneum
· LBSD01 – Laparoscopic partial excision of the Fallopian tube any LGSA-code.
Grouping (depending on length of stay):
· DRG 362X – Laparoscopic or other endoscopic sterilization
· DRG 362O – Laparoscopic or other endoscopic sterilization, short therapy
In the Norwegian version (and other countries), there is a clear distinction between DRG 361X – Gynecological laparoscopy or sterilization via laparotomy / 361O – Gynecological laparoscopy or sterilization via laparotomy, short therapy and DRG 362X/362O, where DRG 361X/361O applies to laparoscopy and DRG 362X/362O applies to sterilization.
In the example presented above, the main reason for the patient’s contact with the healthcare service is diagnostic laparoscopy. We therefore believe that the stay should group to DRG 361X/361O not DRG 362X/362O.
We also have noted that certain relevant laparoscopy procedures should have the grouping property PROCPR 13S03 – Laparoscopy or incisional tubal interruption, but currently have PROCPR 13S08 – Other female reproductive system OR procedure. We therefore propose changing the grouping property from 13S08 to 13S03 for the following procedures:
· JASL21 – Laparoscopic extirpation or destruction of lesion of the peritoneum
· JASL24 – Laparoscopic excision of local lesion of the pelvic wall
· JASL97 – Other laparoscopic local procedure of the peritoneum
This change would result in the example above grouping to DRG 361X/361O. See the attached TC.
We would also like to discuss whether the names of DRG 361X/361O and DRG 362X/362O in the combined version should be revised to more clearly reflect this distinction. It appears that such a distinction already exists in a number of countries, based on the local DRG-names.