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<div class="journal-details-container"> <h4> Task #813 has been updated by Kristiina Kahur. </h4> <div class="details"> <span><strong>Subject</strong> changed from <i>Changes required in NordDRG tools (NDMS, grouper, def. tables)</i> to <i class="new-value">DRG-MDC vs DG-MDC</i></span><br/> </div> <div id="journal-4817-notes" class="note"><p><strong>Nordic Casemix Center/Kristiina Kahur 22-1-2025</strong></p><p>This is to clarify the issues which require changes in NordDRG tools (NDMS, grouper, def. tables). Based on that, the original text of this ticket was changed from "<i><span>DRG-MDC vs DG-MDC"</span></i><span> to </span><i><span>“Changes required in NordDRG tools (NDMS, grouper, def. tables)”</span></i><span> to reflect the actual content of this ticket.</span></p><p>The issues are taken from a Word file attached to <span class="mention" data-mention="#822"><a class="issue tracker-8 status-1 priority-20 priority-lowest multieditable-container scheme scheme-4" title="Development initiative: Further development of NordDRG (Active)" href="https://nordcaseforum.easyredmine.com/issues/822">#822</a></span>. </p><p>They are not directly related to transition to ICD-11 but given that the transition will require changes in NDMS, grouper and/or def.tables anyway, it would make sense to manage all the necessary changes at once. </p><p>The suggested changes are as follows:</p><ol> <li>Change the heading ‘mdc’ in the table drglogic to ‘mdc_dg’ (= mdc of diagnosis) and the heading ‘mdc’ in the table drg_name to ‘mdc_drg (= mdc of drg)’ <i>This will show that the term MDC is used in two different contexts in NordDRG</i> </li> <li>In the table drg_logic, rename the columns procpro and secpro to procpro1 and procpro2, similar to the dgprop columns. <i>The term “secpro” is not present in the table proc_feat and the meaning is not obvious. </i> </li> <li> <span>Harmonise the abbrevation of grouping features throughout the def.tables (and NDMS and grouper), no matter what table they are in. The differences in abbreviations are:</span><ul> <li> <span>Principal diagnosis property</span><ul> <li><span>pdgprop in table drg_logic & pdgprop_name</span></li> <li><span>PDGPRO in table dg_feat</span></li> </ul> </li> <li> <span>Operation room procedure property</span><ul> <li><span>or_proc in table drg_logic</span></li> <li><span>OR in table proc_feat</span></li> </ul> </li> <li> <span>Procedure property</span><ul> <li><span>procpro in table drg_logic</span></li> <li><span>PROCPR in table proc_feat</span></li> <li><span>procprop in table procprop_name</span></li> </ul> </li> </ul> </li> <li>Extra columns in the table drglogic for <u>administrative parameters</u> as the type of care, type of contact and type of profession of the health care personal. <i>Currently they are in the fields for diagnoses and procedures</i>. </li> <li>Extra columns in the table drglogic for interventions. <i>Now there are only two columns for interventions so the columns dgprop 1-4, originally meant for diagnoses, have to be used also for interventions if a grouping rule is based on more than two procedure codes.</i> </li> <li>Enable multiple coding for procedures (similar to asterisk-dagger for diagnoses) so that general qualifiers (NCSP codes beginning with Z) are hooked to the right intervention code. <i>With the present logic, an irrelevant bilateral procedure (e.g. peripheral intravenous catheters) can lead to a DRG for major bilateral interventions (e.g. DRG 471N ‘Bilateral or multiple major joint procs of extremities’). If the problem will be solved in ICHI, we can skip this suggestion.</i> </li> </ol><p>This case remains further active.</p><p> </p></div></div> <hr/> <p><strong>Mats Fernström, the National Board of Health and Welfare, Sweden 2022-02-01</strong> (Swe ID C913)<br>The term MDC is used in two completely different meanings in NordDRG. In the table drg_logic, MDC means the MDC to which the principal diagnosis must belong to and in the table drg_name, MDC means the MDC to which the DRG belongs. It is not always so that the MDC of the principal diagnosis is the same as the MDC of the DRG. In the Swedish version of NordDRG for 2022 there are 251 rules where the MDC of the principal diagnosis differs from the MDC of the DRG outcome, which corresponds to 194 different DRGs.</p><p>To make the grouping logic more transparent and to avoid future misunderstandings we suggest that the headline ‘mdc’ in the table drglogic is changed to dg_mdc (= diagnosis-mdc) and that the headline ‘mdc’ in the table drg_name is changed to drg_mdc.</p>
