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DTSTAMP:20260625T130046Z
UID:865@nordcaseforum.easyredmine.com
DTSTART:20230221T000000
DTEND:20230221T000000
CLASS:PUBLIC
CREATED:20230221T134231
DESCRIPTION:Problem A suggestion from the medical professionals at Vestre v
 iken hospital about procedure code KEB06G "Biopsi av prostata\, MR-veilede
 t" and KEB06K "Nålebiopsi av prostata\, ultralydveiledet".  New guideline
 s today advise against transrectal biopsies and rather biopsies using a mo
 re percutaneous technique through the perineum. The old biopsy needles can
 not be used. The spring/motor is too weak. One must therefore choose more 
 expensive biopsy equipment. Cases with diagnosis codes in MDC 23 will grou
 p to DRG 923O where medical professionals at Vestre viken indicates that t
 he reimbursement is too low compared with the cost.&nbsp\;   Analysis  The
  procedure code KEB06G and KEB06K are used as procedure code 23 and 3 482 
 times during 2021. Where procedure code KEB06G is used\, the cases are mai
 nly grouped to DRG 877O "Andre polikliniske kontakter for gjennomføring a
 v middels omfattende prosedyrer". Where procedure code KEB06K is used\, 47
 % of the cases goes to DRG 812P "Mindre prosedyrer på mannlige kjønnsorg
 an" and 37% are going to DRG 923O "Pol kons vedr faktorer som har betydnin
 g for helsetilstanden/kontakt med helsetjenesten".  In DRG 812P where proc
 edure code KEB06K is used are the diagnostic codes C61 "Ondartet svulst I 
 blærehalskjertel"\, N40 "Benign prostataobstruksjon" and Z125 "Populasjon
 sbasert screening mhp. Svulst I blæehalskjertel" are mostly used. In 923O
  with procedure code KEB06K\, diagnostic codes R748 "Unormalt serumnivå a
 v andre spesifiserte enzyme" and R749 "Unormalt serumnivå av uspesifisert
  enzym" are mostly used.&nbsp\; &nbsp\;  DRG 812P "Mindre prosedyrer på m
 annlige kjønnsorgan" have cost weight 0\,037 which would be about 69 EURO
  (723 NOK) in ISF reimbursement.  DRG 923O "Pol kons vedr faktorer som har
  betydning for helsetilstanden/kontakt med helsetjenesten" have cost weigh
 t 0\,017 which would be about 30 EURO (336 NOK) in ISF reimbursement.  DRG
  812P Total number of cases in 2021: 10 391&nbsp\; Mean cost: 210 EURO (2 
 308 NOK)  DRG 812P with procedure code KEB06K Total number of cases in 202
 1: 1 636 Mean cost: 260 EURO (2 868 NOK)  DRG 923O Total number of cases i
 n 2021: 154 611 Mean cost: 241 EURO (2 658 NOK)  DRG 923O with procedure c
 ode KEB06K Total number of cases in 2021: 1 891 Mean cost: 275 EURO (3 030
  NOK)   Medically the solution with the cases that are grouped to DRG 923O
  are not optimal\, and DRG 812P would be more medical meaningful and homog
 eneous in terms of costs. &nbsp\;   Suggestion  We suggest creating a new 
 procedure property 12O02 "Biopsy of the prostate" and give this to the cod
 es KEB06K\, KEB06G\, KEX03 and KEX06. We also suggest creating a new rule 
 in drglogic with procpro 12O02 and MDC 23.  We had to do a correction with
  code KEB06G and take out PROCPRO 11O01 "Puncture of kidney and retroperit
 oneum" and OR 2. That’s because the code had the wrong property compared
  to other comparable codes.  We have also been thinking about giving MDC 2
 3 to DRG812P and procedure property 12O01 instead of 12O02\, but then we n
 oticed that regrouped a lot of cases from DRG 823R "Mindre prosedyrer vedr
  faktorer som har betydning for helsetilstanden/ kontakt med helsetjeneste
 n" with Z090 and Z080 as diagnosis code and KXFF00 as procedure code which
  does not fit in DRG 812P.   DRG change When testing this change\, this wi
 ll in the Norwegian 1. Tertial 2021 national data regroup 1 016 cases: Fro
 m 923O to 812P: 906 From 912O to 812P: 43 From 823R to 812P: 28 From 811P 
 to 812P: 15 From 877O to 812P: 12 From 811R to 812P: 7 From 718O to 812P: 
 3 From 811P to 811S: 2 &nbsp\;
LAST-MODIFIED:20230508T070117
ORGANIZER:mailto:mats.ulvund.paulsberg@helsedir.no
PRIORITY:5
SEQUENCE:0
STATUS:CONFIRMED
SUMMARY:Regroup prostate biopsy from MDC 23 to MDC 12
URL;VALUE=URI:https://nordcaseforum.easyredmine.com/issues/865
ATTENDEE;CN=Mats Ulvund Paulsberg:mailto:mats.ulvund.paulsberg@helsedir.no
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