Finland does not want this change in our 2027 version.
 

When analyzing our data we found no cases where proc code KEDE1A (KE1AE Eturauhasen ultraäänitutkimus) had been used, so we couldn’t compare costs between these two procedures.
 

Cases where proc code KEDE1B (KE1BE Eturauhasen ultraäänitutkimus peräsuolen kautta) had been used were mainly grouped to either 912O Disease or disorder of the male reproductive system, short therapy w/o significant procedure or 911O Disease or disorder of the kidney and urinary tract, short therapy w/o significant procedure. The mean cost for 912O was 274 € (for 912O cases where KEDE1B had been used 394 €) and for 911O 326 € (448€ for the cases where KEDE1B had been used).
 

If OR value for KEDE1B was changed to 2, the cases would mainly be grouped to either 812O Non-extensive procedure of male reproductive system, short therapy (mean cost 967 €) or 811O Non-extensive procedure of urinary tract, short therapy  (mean cost 937 €). In terms of cost homogeneity, KEDE1B cases do not really fit into these two groups.
 

Clinically we do acknowledge that resourcewise KEDE1B is more demanding than KEDE1A. However, as Finland is aiming to work on the gender neutral grouping this year and this would be a part of that solution, we don’t want to change the OR value at this point.

Mats Fernström, the National Board of Health and Welfare, Sweden, 2026-02-24 (SWE ID C1048)  

2025-09-03 Kristiina wrote “it might be reasonable for countries to have a look and check the OR values of all ultrasound codes”. We agree on that because we are not consistent on that matter. Some have OR 1, some OR 2 but most have OR 0. 

In the Swedish version of NordDRG, the OR property 2 has a rather low impact. Out of 4 576 rules in the table drg_logic there are only 120 rules with the letter P. Most of them (109 rules) are about endoscopy. However, the OR value can be seen as a very rough estimate of resource consumption and then we have thought of a principal thinking:  

• Ultrasound procedures that require laparotomy, laparoscopy, thoracotomy, or incision of the skin could have OR 1. 
• Ultrasound procedures that require endoscopy could have OR 2. 
• Ultrasound procedures that are performed transcutaneous could have OR 0 (zero) except when needle biopsy is performed, then OR 2 is probably more adequate. 

With this principle in mind, we tried the following six changes on our patient database for 2024: 

• AF032 Intrakoronart ultraljud och doppler (FNDE1B Intravascular ultrasonography of coronary arteries) from OR 2 to OR 1. 
• AP052 Intravasalt ultraljud (PXDE1B Endovascular ultrasonography) from OR 2 to OR 1 
• TKE20 Punktionsbiopsi av prostata med MR-ultraljudsfusionsteknik, transrektal (KEXX00 Prostate needle biopsy) from OR 0 to OR 2. 
• TKE23 Punktionsbiopsi av prostata med MR-ultraljudsfusionsteknik, transperineal (KEXX00 Prostate needle biopsy) from OR 0 to OR 2. 
• XGX10 Intrapleural ultraljudsundersökning (GXDE00 Intrapleural ultrasonography) from OR 2 to OR 1. 
• XPX30 Endovaskulärt ultraljud (PXDE1B Endovascular ultrasonography) from OR 2 to OR 1. 

The result was that we got a lot of cases in DRG Z60 ‘Annan sällsynt, eller felaktig, kombination av huvuddiagnos och åtgärd’ (DRG 477 ‘Other rare or incorrect combination of principal diagnosis and procedure’) because of the change from OR 2 to OR 1 for FNDE1B, PXDE1B and GXDE00. The question then is whether these cases really are incorrectly primary coded or whether the grouping logic needs to be supplemented with new rules that lead to adequate descriptive DRGs. We need to investigate this further, which will take time so it will not be finished to the EG meeting. Thus, we want to postpone this task. In the meantime, the group can consider our proposal for principles. 

We reviewed the additional procedure codes whose OR value Sweden wants to change, and Finland does not want this change.

In principle, we understand the reason behind the proposal. However, when analysing our data, we noticed that only three of these codes: FN1BE Sepelvaltimoiden ultraäänitutkimus katetrin kautta (FNDE1B Intravascular ultrasound of coronary arteries), XGX10 Ultraäänitutkimus keuhkon pinnalta (GXDE00 Intrapleural ultrasound) and KE1AT Eturauhasen kudosnäytteen otto UÄ-ohjauksessa  (KEXX00 Needle biopsy of prostate) were used, and all of them also have a specific PROCPR that actually determines the grouping result, not the OR value:

FNDE1B -> PROCPR 05S05 Cardiac catheterization

GXDE00 -> PROCPR 04E02 Endoscopy of airways and organs for respiratory problems

KEXX00 -> PROCPR 12V02 Male genital intervention.

Also, as mentioned above, our plan is also to develop a gender-neutral grouping logic, to which some of these codes belong.

In the Latvian data, in 2025, similarly to Finland, there are no ultrasound codes coded extensively. In principle - KEDE51 once and GXDE00 116 times. Latvia refuses these changes.

Estonia does not need this change.