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<div class="journal-details-container"> <h4> Task #925 has been updated by Kristiina Kahur. </h4> <div id="journal-4822-notes" class="note"><p><strong>Nordic Casemix Centre/Kristiina Kahur 29-1-2025</strong></p><p>This is to summarize the situation with e<span>ndoscopic submucosal dissection (ESD) in NordDRG 2025PR versions.</span></p><p><span>There are three national versions (ICE, FIN and SWE) having ESD codes in their def.tables. The codes are determined based on anatomical location. </span></p><p><span>In total, there are five different ESD codes:</span></p><p><span>JCSA14 </span><i><span>Endoscopic submucosal dissection in the esophagus</span></i><span> (in SWE, FIN and ICE version)</span><br><span>JDSA46 </span><i><span>Endoscopic submucosal dissection in the stomach</span></i><span> (FIN and ICE)</span><br><span>JFSA44 </span><i><span>Endoscopic submucosal dissection in the small intestine</span></i><span> (SWE)</span><br><span>JFSA87 </span><i><span>Endoscopic submucosal dissection in the large bowel</span></i><span> (FIN and ICE)</span><br><span>JGSA14 </span><i><span>Endoscopic submucosal dissection in the rectum</span></i><span> (SWE, FIN, ICE)</span></p><p><span>Apart from OR value which is 2 for all codes, and PROCPR 40V78 </span><i><span>Code not compatible with follow-up</span></i><span> which is used only in SWE version, the other grouping features (PROCPRs) of each code vary:</span></p><p><span><u>JCSA14 Endoscopic submucosal dissection in the esophagus (swe/fin/ice) </u></span><br><span>PROCPR 03E06 Therapeutic endoscopy of upper gastrointestinal tract for ENMT problem</span><br><span>PROCPR 03S12 Other ear, nose, mouth or throat OR procedure</span><br><span>PROCPR 04S02 Other respiratory system OR procedure</span><br><span>PROCPR 06E06 Therapeutic endoscopy of upper gastrointestinal tract for gastrointestinal problem</span><br><span>PROCPR 06S10 Other digestive system OR procedure</span><br><span>PROCPR 14S90 Significant operation for obstetrical patient</span><br><span>PROCPR 17E06 Other therapeutic endoscopy of upper gastrointestinal tract for myeloproliferative diseases</span><br> </p><p><span><u>JDSA46 Endoscopic submucosal dissection in the stomach (fin/ice) </u></span><br><span>PROCPR 06E06 Therapeutic endoscopy of upper gastrointestinal tract for gastrointestinal problem</span><br><span>PROCPR 06S10 Other digestive system OR procedure</span><br><span>PROCPR 17E06 Other therapeutic endoscopy of upper gastrointestinal tract for myeloproliferative diseases</span><br> </p><p><span><u>JFSA44 Endoscopic submucosal dissection in the small intenstine (swe) </u></span><br><span>PROCPR 06E04 Therapeutic enteroscopy</span><br><span>PROCPR 06S06 Small or large bowel procedure</span><br><span>PROCPR 17E04 Therapeutic enteroscpy for myeloproliferative disease</span><br> </p><p><span><u>JFSA87 Endoscopic submucosal dissection in the large bowel (fin/ice) </u></span><br><span>PROCPR 06E10 Colonoscopy for gastrointestinal diseases</span><br><span>PROCPR 06S06 Small or large bowel procedure</span><br><span>PROCPR 17E10 Colonoscopy for myeloproliferative disease</span><br> </p><p><span><u>JGSA14 Endoscopic submucosal dissection in the rectum (swe/fin/ice) </u></span><br><span>PROCPR 06E10 Colonoscopy for gastrointestinal diseases</span><br><span>PROCPR 06S06 Small or large bowel procedure</span><br><span>PROCPR 17E10 Colonoscopy for myeloproliferative disease</span><br> </p><p><span>The grouping features are to large extent the same compared to respective codes for endoscopic mucosal or submucosal resection (EMR) which means that the assignment of cases to DRGs is similar regardless of method (EMR or ESD).</span></p><p><span>Given that ESD and EMR are different in terms of resource use it would be very much appreciated if any of the countries which has cost data could conduct an analysis and share the results before the EG meeting to facilitate the further revision and changes of grouping features of ESD codes.</span></p><p> </p></div></div> <hr/> <p>Endoscopic submucosal dissection (ESD) is a minimally invasive procedure to remove growths from the lining of the gastrointestinal (GI) tract without surgery. It may offer a cure for early-stage cancers of the esophagus, stomach and colon. This is an expensive procedure - time consuming and uses very precise and expensive electrosurgical knife. An ESD is an evolution of an older technique called endoscopic mucosal resection (EMR). ESD is more expensive, difficult and time consuming than EMR.</p><p>Iceland is now starting to use this ESD treatment. Are other countries using it also, and how is it grouped there? A possible DRG group might be 703O Endoscopic insertion of stent or ablation treatment of gastrointestinal tract, short therapy. Now, only endoscopic treatments of esophagus and stomach group into 703O.</p><p>Any comments would be appreciated.</p>
