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<div class="journal-details-container"> <h4> Task #818 has been updated by Kristiina Kahur. </h4> <div id="journal-4814-notes" class="note"><p><strong>Nordic Casemix Center/Kristiina Kahur 22-1-2025</strong></p><p>Even though this case is related to the changes concerning the transition to ICD-11, there is a need for a thorough analysis from clinical and economical point of view how <span>two or more diagnosis codes with CC would generate MCC feature and grouping a case into DRG with MCC. </span></p><p><span>Currently, the amount of diagnosis codes with CC per case does not affect the grouping to DRG with MCC. Instead the variable COMPL with ‘G’ in the middle is decisive.</span></p><p>As this task was initiated by Sweden, I would like Swedish colleagues to have a look at this and assess the need for this change (whether in short or long run) and your capacity to conduct the analysis.</p><p>I also encourage other countries to have a look at the initial suggestion and provide your feedback if any thoughts or comments.</p></div></div> <hr/> <p><strong>Mats Fernström, the National Board of Health and Welfare, Sweden 2022-02-17</strong> (SWE ID C926)<br>It has been pointed out that I did not mention inactive complication categories with the letter J in my documents “How to read NordDRG definition tables 2021-12-20” and “How to write technical changes for NordDRG - 2021-12-21”. <br>The purpose of COMPL values with the letter J is that they shall be activated to a corresponding COMPL value with the letter G (= MCC level) by certain DGPROP values (similar to activation of COMPL values with the letter I) and then potentially leading to a DRG of the type “very complicated”, i.e. with MCC.<br>I intentionally omitted this, because inactive complication categories with the letter J are not used in any version of NordDRG and they will probably never be used in the future either. What diagnosis should have the potential to elevate a patient case from ‘not complicated’ all the way to ‘very complicated’ without already having a COMPL value with the letter G? I doubt that we will find such a diagnosis.</p><p>Then I believe more in developing NordDRG so that two or more diagnoses with CC property will generate MCC property. Something that speaks for this, is that there is a strong connection between the number of diagnoses and cost, see the enclosed file Cost_number_dx.xlsx. <br>A function that generates a MCC property when two or more CC properties are present cannot just count the number of diagnoses, however. It will be too blunt. We experts must be able to choose which categories that should generate MCC property. Technically, it can be done in a similar way as the present activation of inactive complication categories.</p><p>The suggested development of NordDRG demands changes in the program code for the groupers so it could preferably be done in connection with transition to ICD-11, when the groupers must be re-programmed anyhow. <br>If there is an interest in such a development, we can go on with the analysis and suggest some complication categories that together should lead to "MCC". Otherwise, we close the case (or continue on the sly).</p>
