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<div class="journal-details-container"> <h4> Task #1005 has been updated by Kristīne Putniņa. </h4> <div id="journal-5516-notes" class="note"><p>There are 60 ultrasound codes in the LAT definition tables. When reviewing the proc prop OR according to Matsš / Lotta's opinion, we identified a need to change procprop for one of the ncsp codes: XGX96 | Cita veida intraoperatīva krūškurvja ultrasonogrāfija (plus code GXDE09 | Other intraoperative thoracic ultrasonography), OR: 2 → 1. </p><p>In addition, I identified two cases in the LAT definition table where the same procedure text has two different codes:</p><ul> <li data-list-item-id="e104eed2facb1aab3dcde6b16b79452d1">JHDE00 | Transanāla ultrasonogrāfija (not coded during the 2026_7M period) and XJH00 | Transanāla ultrasonogrāfija (currently used in medical documentation). Both are mapped to plus procedure JHDE00 – Transanal ultrasonography.</li> <li data-list-item-id="e8baabf9be0053e15a8d6d533dc967352">KDDE10 | Transuretrāla ultrasonogrāfija and XKD10 | Transuretrāla ultrasonogrāfija. Both are mapped to proc plus KDFD10 – Transurethral ultrasonography. </li> </ul><p>There is also XFE00 | Epikardiāla ultrasonogrāfija (ENG: Epicardial ultrasonography) and XFX30 | Epikardiāla sirds ultrasonogrāfija (ENG: Epicardial heart ultrasonography), which in our understanding, refer to the same procedure.</p><p>The procprop codes for those 3 proc pairs are identical. Therefore, we believe that one code from each pair could potentially be deleted.</p><p>Could NCC please clarify whether there is any rationale reasone for having these duplicate codes, and whether there are any contraindications to delete one of the code from each pair?</p><p>Thank you in advance for your clarification.</p><p>In common we agree to Mats's and Lotta's opinion regarding usg proc OR prop.</p></div></div> <hr/> <p>With a reference to <span class="mention" data-mention="#982" data-mention-uid="e904a598"><a class="issue tracker-2 status-5 priority-21 priority-default multieditable-container closed" title="Case: OR value of proc codes KEDE1B and KEDE1A (on other ultrasound examination codes) (Closed)" onclick="if (!event.metaKey && !event.ctrlKey && event.button === 0) { event.preventDefault(); EasyVue.showModal('issue', 982); return false; }" href="https://nordcaseforum.easyredmine.com/issues/982">#982 - OR value of proc codes KEDE1B ...</a></span>, it was decided in EG Spring meeting that we create a new case to allow countries to have a look and check the OR values of all ultrasound codes as they lack consistency - some have OR 1, some OR 2 but most have OR 0. </p><p>Text written by Sweden/Mats is copied here:</p><p>In the Swedish version of NordDRG, the OR property 2 has a rather low impact. Out of 4 576 rules in the table drg_logic there are only 120 rules with the letter P. Most of them (109 rules) are about endoscopy. However, the OR value can be seen as a very rough estimate of resource consumption and then we have thought of a <u>principal</u> thinking: </p><ul> <li data-list-item-id="e80279baa4a1659ffc0bd4c572e64bf39">Ultrasound procedures that require laparotomy, laparoscopy, thoracotomy, or incision of the skin could have OR 1. </li> <li data-list-item-id="e968f91a85699e2c341bb48385e1d506f">Ultrasound procedures that require endoscopy could have OR 2. </li> <li data-list-item-id="ebe7f6a38466150cc61ced6fd6c6f2843">Ultrasound procedures that are performed transcutaneous could have OR 0 (zero) except when needle biopsy is performed, then OR 2 is probably more adequate. </li> </ul><p>With this principle in mind, we tried the following six changes on our patient database for 2024: </p><ul> <li data-list-item-id="e52df273772ab25ec5b00c64bc0f1e7d6"> <strong>AF032</strong> Intrakoronart ultraljud och doppler (<strong>FNDE1B</strong> Intravascular ultrasonography of coronary arteries) <i>from OR 2 to OR 1</i>. </li> <li data-list-item-id="e36f736adf207c13ee2f51d5d620ccc5d"> <strong>AP052</strong> Intravasalt ultraljud (<strong>PXDE1B</strong> Endovascular ultrasonography) <i>from OR 2 to OR 1</i> </li> <li data-list-item-id="e31cd5de323ac3deaa04cb1ff55144d9c"> <strong>TKE20</strong> Punktionsbiopsi av prostata med MR-ultraljudsfusionsteknik, transrektal (<strong>KEXX00</strong> Prostate needle biopsy) <i>from OR 0 to OR 2</i>. </li> <li data-list-item-id="e382473c058522bfa7f93bcafe8055f0e"> <strong>TKE23</strong> Punktionsbiopsi av prostata med MR-ultraljudsfusionsteknik, transperineal (<strong>KEXX00</strong> Prostate needle biopsy) <i>from OR 0 to OR 2</i>. </li> <li data-list-item-id="e22c1af97f6b690c7fbc1713d9a02cdbc"> <strong>XGX10</strong> Intrapleural ultraljudsundersökning (<strong>GXDE00</strong> Intrapleural ultrasonography) <i>from OR 2 to OR 1</i>. </li> <li data-list-item-id="e890b3864650fd8402398d9f6b84ac207"> <strong>XPX30</strong> Endovaskulärt ultraljud (<strong>PXDE1B</strong> Endovascular ultrasonography) <i>from OR 2 to OR 1.</i> </li> </ul><p>The result was that we got a lot of cases in DRG Z60 ‘Annan sällsynt, eller felaktig, kombination av huvuddiagnos och åtgärd’ (DRG 477 ‘Other rare or incorrect combination of principal diagnosis and procedure’) because of the change from OR 2 to OR 1 for FNDE1B, PXDE1B and GXDE00. </p><p>The question then is whether these cases really are incorrectly primary coded or whether the grouping logic needs to be supplemented with new rules that lead to adequate descriptive DRGs. </p><p> </p><p>Using this as a starting point, all countries are kindly invited to share their thoughts on three principles Mats is suggesting when it comes to determining the OR value of ultrasound procedures and check the data if they support this. If not, or if countries suggest different approach, please share via this ticket.</p><p> </p><p>The task type is currently set to ‘Development initiative.’</p>
