BEGIN:VCALENDAR VERSION:2.0 PRODID:icalendar-ruby CALSCALE:GREGORIAN METHOD:PUBLISH X-MS-OLK-FORCEINSPECTOROPEN:FALSE BEGIN:VEVENT DTSTAMP:20260626T125438Z UID:690@nordcaseforum.easyredmine.com DTSTART:20200225T000000 DTEND:20200225T000000 CLASS:PUBLIC CREATED:20200225T130340 DESCRIPTION:The goal To allow continuous maintanance of ATC codes in NDMS a nd to allow their use in DRG assignment. Background Different NordDRG ver sions have used ATC-system to identify drugs both as componets of diagnost ic information and as compoments of intervention information. \; For t his purpose the the ATC information has been imported to the grouper eithe r as secondary diagnosis code or as intervention code. \; Local system s have usually not been capable to handle 7 character codes as dx or proce dure codes and therefore also the old NDMS was not designed to use more th an 5 characters of the ATC ccodes. However it is obvious that a major par t of the information is lost when shortening the code to 5 characters. For this reason one has in Finland used for a number drugs the 5 last charact ers of the ATC code. This obviously looses the main part of the informatio n\, but for limited puposes this has worked. \; The new NDMS is now ca pable to handle as many characters as wanted \; At least in Finland TH L has also started to collect 7 character ATC information and thus it seem s possible to get full length ATC code information from the hospitals. Be cause of the ongoing change we have not updated the ATC codes other than t hose that are actually used in NDMS and thus even the 5 character codes do not match with WHO Collaborating Centre for Drug Statistics Methodology ( WHOCC) official classification. At least Sweden has expressed a need to up date the ATC codes. Our plan is now to implement all 5- and 7-charcter AT C codes to NDMS and I have donloaded the uptodate classification from WHOC C. The price of the download is 200€ and it seems that the national vers ions may not include the english text that is only available from WHOCC. The comparison with finnish official version on the National code server r evealed that a number of the national codes are not included in the up-to- date WHOCC version of ATC. The Finnish Medicines Agency (FIMEA) that is su pposed to maintain the classification also on the code server has an almos t perfectly updated version on their own web-site (only to WHOCC codes are missing). Of the ATC codes that are included in the Swedish NordDRG defi nition tables quite many seem not to be included in the WHOCC ATC version. I have not checked for a complete ATC version from Sweden as I did not ha ve readily available. The problem seems to be that ATC system adds tempor ary codes that are later modified when 'correct' code is invented. WHOCC a nd FIMEA do not maintain history of the codes nor the mapping of old codes to current codes in the published versions of the system. The non matchin g national concepts usually exist in the WHOCC version but with another co de. An additional problem is that we have an almost complete Swedish tran slation of the WHOCC ATC codes form FIMEA\, but the translations are diffe rent in Sweden and Finland. In the future it might be optimal to maintain the ATC system as a separate basic classification that is used by both di agnostic and intervention components of the system. Technical change  \; We propose that all WHOCC 5- and 7-charcter codes are added to both pro cedure codes and Dx codes in NDMS. \; As diagnosis all ATC codes will belong to diagnosis category 00M00. This means that ATC codes cannot be us ed as principal diagnosis but some of them may have grouping properties (d iagnosis properties) that affect DRG assignment. The properties that 5-cha racter codes currently have will be given to all 7-character codes that ar e 'children' of the 5-character codes. \; As intervention codes the (u sed by Fin and Nor) the ATC codes will all have OR=0 property. They do not affect DRG assignment as surgical intervetions.They may have procedure pr operties (and grouping properties) and affect through these properties the assignment. When 7-character codes are added the properties are copied fr om existing codes to corresponding 7 character codes. \; As a second p hase the 5-charcter codes will be omitted and the current codes will linke d to the residuall group of the 7-chracter codes. DRG change The goal is that this change will not affect the DRG assignment at all. \; The cou ntries may continue to use the existing codes as they will be linked wit c odes with the current properties. LAST-MODIFIED:20230315T170301 ORGANIZER:mailto:martti.virtanen@nordcase.org PRIORITY:5 SEQUENCE:0 STATUS:CONFIRMED SUMMARY:Use of ATC codes in NordDRG and NDMS URL;VALUE=URI:https://nordcaseforum.easyredmine.com/issues/690 X-MICROSOFT-CDO-BUSYSTATUS:BUSY X-MICROSOFT-CDO-IMPORTANCE:1 X-MICROSOFT-DISALLOW-COUNTER:FALSE X-MS-OLK-AUTOFILLLOCATION:FALSE X-MS-OLK-AUTOSTARTCHECK:FALSE X-MS-OLK-CONFTYPE:0 END:VEVENT END:VCALENDAR