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DTSTAMP:20260625T143004Z
UID:1015@nordcaseforum.easyredmine.com
DTSTART:20260526T000000
DTEND:20260526T000000
CLASS:PUBLIC
CREATED:20260526T170200
DESCRIPTION:Mats Fernström\, the National Board of Health and Welfare\, Sw
 eden\, 2026-05-26 (SWE ID C1046)  We have noticed that some cases with rec
 onstruction of craniofacial malformation are grouped to DRG Z50 “Tyngre 
 sällsynt\, eller felaktig\, kombination av huvuddiagnos och åtgärd …
 ” (DRG 468 “Rare or incorrect combination of diagnosis and extensive p
 rocedure\,…”). This happens when the principal diagnosis ICD code is Q
 870 ”Medfödda missbildningssyndrom som främst påverkar ansiktets utse
 ende” (Q8700 Congenital malformation syndromes predominantly affecting f
 acial appearance) or the Swedish subgroups combined with the procedure cod
 es AAK20 “Operationer p.g.a. kraniosynostos” (AASK20 “Operations for
  craniosynostosis”) or AAK30 “Kraniofacial rekonstruktion vid missbild
 ning” (AASK30 “Craniofacial reconstruction in congenital malformations
 ”). The reason for DRG Z50/468 and not DRG Z60/477 is that both AAK20/ A
 ASK20 and AAK30/ AASK30 have procpro 99S90.  The combinations of diagnoses
  codes and procedure codes mentioned above are correct to use according to
  the classification team at the National Board of Health and Welfare and t
 hen DRG Z50/468 is unsatisfactory. Therefore\, we suggest adding procpro 0
 3S01 (Major head or neck procedure) to AAK20/ AASK20 and AAK30/ AASK30. Th
 en the cases will be grouped to DRG C05N/ 049A with the text “Other majo
 r operations on head and neck” which is much better than “Rare or inco
 rrect combination of diagnosis and extensive procedure” from a descripti
 on perspective.  What about the cost perspective? In our latest cost datab
 ase\, we found:  \n 42 cases with AAK20/ AASK20\, with an average cost of 
 221&nbsp\;207 SEK \n 16 cases with AAK30/ AASK30\, with an average cost of
  259&nbsp\;268 SEK \n  The average cost for DRG Z50E/468 is 153&nbsp\;334 
 SEK while the average cost for DRG C05N/ 049A is 165 806 SEK. Thus\, DRG C
 05N/ 049A is somewhat better than DRG Z50E/468 also from a cost perspectiv
 e.  In summary\, we want to add procpro 03S01 to AAK20/ AASK20 and AAK30/ 
 AASK30 in NordDRG SWE2028\, which will lead to a better grouping\, both in
  description and cost perspectives. A TC for this small change is attached
 .
LAST-MODIFIED:20260602T071957
ORGANIZER:mailto:mats.fernstrom@socialstyrelsen.se
PRIORITY:5
SEQUENCE:0
STATUS:CONFIRMED
SUMMARY:Craniofacial reconstruction leads to a Z-DRG
URL;VALUE=URI:https://nordcaseforum.easyredmine.com/issues/1015
ATTENDEE;CN=Mats Fernström:mailto:mats.fernstrom@socialstyrelsen.se
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