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DTSTAMP:20260625T154023Z
UID:1013@nordcaseforum.easyredmine.com
DTSTART:20260429T000000
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CREATED:20260429T081134
DESCRIPTION:This case concerns PROCPR 99S90 Extensive procedure - list crea
 ted during the exporting process and how it is used across all national ve
 rsions.  Use of PROCPR 99S90 was reviewed both from a clinical perspective
  and from the perspective of cross‑country differences.  There is no cle
 ar definition of “extensive procedure”. However\, in casemix or DRG co
 ntext one could define it as a procedure with high resource intensity that
  significantly increase expected costs\, length of stay\, complexity\, and
  clinical risk. Its role is primarily grouping logic\, not clinical descri
 ption.  In the NordDRG system\, PROCPR 99S90 is used to identify extensive
  procedures and\, on that basis\, to allow grouping to DRG 468/X &nbsp\;Ra
 re or incorrect combination of diagnosis and extensive procedure/X. This d
 istinction is necessary to separate cases that are not considered extensiv
 e\, which are instead grouped to DRG 477/X Rare or incorrect combination o
 f diagnosis and other procedures/X.  In addition\, PROCPR 99S90 is used in
  the rules of following DRGs: \n\ndrg_comb\ndrg_text_comb\nnat_ver\n\n\n44
 2X\nOther OR procedures for injuries\, w CC\nest/lat/ice/fin/nor\n\n\n443M
 \nOther major OR procedures after injuries\, w MCC\nswe\n\n\n443C\nOther m
 ajor OR procedures in general anaesthesia for injuries\, w CC\nswe\n\n\n44
 3N\nOther major OR procedures in general anaesthesia for injuries\, w/o CC
 \nswe\n\n\n443X\nOther OR procedures for injuries\, w/o CC\nest/lat/ice/fi
 n/nor\n\n PROCPR 99S90 with minus (-) sing is not used in any DRG rules (m
 inus sign is used in case to avoid grouping of case with a procedure code 
 having PROCPR 99S90).  &nbsp\;  After having a look at the used on PROCPR 
 99S90\, here are some observations:   There are procedure codes which are 
 having OR value 0 or 2\, yet having PROCPR 99S90. The codes are as follows
 :  \n\ncode_plus\ntext_plus\nor_val\nnat_ver*\n\n\nJCSE35\nLaprascopic ope
 ration on oesophageal atresia or congenital tracheo-oesophageal fistula\n0
 \nnor\n\n\nNHSQ60\nRevision of ampution or exarticulation of ankle or foot
 \n0\nice/fin\n\n\nFKSC61\nRepair of mitral valve insufficiency by a transl
 uminally inserted clip\n2\nfin/est\n\n\nNAO10D\nTermokoagulasjon i kolumna
 \, CT-veiledet\n2\nnor\n\n\nNAXA00\nHeat coagulation of vertebral lesion\n
 2\nice/fin/nor\n\n\nNAXT60\nManipulation of the spine\n2\nice/fin\n\n *As 
 Norwegian version is primarily maintained by Helsedirektoratet\, there can
  be differences between the tables maintained in NDMS and HS.  2. There ar
 e cross-country differences among some codes: \n\ncode_plus\ntext_plus\nor
 _val\nnat_ver\nComment\n\n\nLESF03\nPosterior colporrhaphy\n1\nest/lat/ice
 /fin/nor\nNot used in SWE version\n\n\nLESF10\nColpoperineoplasty\n1\nest/
 lat/ice/fin/nor\nNot used in SWE version\n\n\nFZSA00\nTotal cardiopulmonar
 y bypass in normothermia or moderate hypothermia at concurrent surgical pr
 ocedure\n1\nswe\nUsed only in SWE version\n\n\nKKSB11\nPercutaneous endosc
 opic excision of retroperitoneal tumour\n1\nswe\nUsed only in SWE version\
 n\n\nLESF40\nVaginal repair of enterocele\n1\nswe\nUsed only in SWE versio
 n\n\n\nLESF41\nLaparoscopic repair of enterocele\n1\nswe\nUsed only in SWE
  version\n\n\nZTXA40\nGraft of synthetic skin substitute\n1\nswe\nUsed onl
 y in SWE version\n\n Things to consider:  \n remove PROCPR 99S90 from proc
 edure codes with OR 0 or 2\, or change the OR value of procedure codes. \n
  harmonise the use of PROCPR 99S90 across countries\, based on the princip
 le that identical procedure codes are interpreted consistently regardless 
 of country\, whether as “extensive” or “non‑extensive". \n Revise 
 all procedure codes from PROCPR 99S90 perspective (see attached a table of
  procedure plus codes with PROCPR 99S90 in 2027PL0 version).&nbsp\; \n Giv
 en that PROCPR text Extensive procedure - list created during the exportin
 g process was used during the transition of definition tables from FoxPro 
 to NDMS in 2018\, I suggest to change the text: Extensive procedure - list
  created during the exporting process -&gt\; Extensive procedure. \n  This
  case is meant to be discussed in next EG Spring meeting. Any comments or 
 views on this issue are welcome any time.
LAST-MODIFIED:20260512T162823
ORGANIZER:mailto:kristiina.kahur@nordcase.org
PRIORITY:5
SEQUENCE:0
STATUS:CONFIRMED
SUMMARY:Use of PROCPR 99S90 Extensive procedure
URL;VALUE=URI:https://nordcaseforum.easyredmine.com/issues/1013
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