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<div class="journal-details-container"> <h4> Task #982 has been updated by Mats Fernström. </h4> <div id="journal-5226-notes" class="note"><p><strong>Mats Fernström, the National Board of Health and Welfare, Sweden, 2026-02-24 </strong>(SWE ID C1048) </p><p>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. </p><p>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 <u>principal</u> thinking: </p><ul> <li>Ultrasound procedures that require laparotomy, laparoscopy, thoracotomy, or incision of the skin could have OR 1. </li> <li>Ultrasound procedures that require endoscopy could have OR 2. </li> <li>Ultrasound procedures that are performed transcutaneous could have OR 0 (zero) except when needle biopsy is performed, then OR 2 is probably more adequate. </li> </ul><p>With this principle in mind, we tried the following six changes on our patient database for 2024: </p><ul> <li> <strong>AF032</strong> Intrakoronart ultraljud och doppler (<strong>FNDE1B</strong> Intravascular ultrasonography of coronary arteries) <i>from OR 2 to OR 1</i>. </li> <li> <strong>AP052</strong> Intravasalt ultraljud (<strong>PXDE1B</strong> Endovascular ultrasonography) <i>from OR 2 to OR 1</i> </li> <li> <strong>TKE20</strong> Punktionsbiopsi av prostata med MR-ultraljudsfusionsteknik, transrektal (<strong>KEXX00</strong> Prostate needle biopsy) <i>from OR 0 to OR 2</i>. </li> <li> <strong>TKE23</strong> Punktionsbiopsi av prostata med MR-ultraljudsfusionsteknik, transperineal (<strong>KEXX00</strong> Prostate needle biopsy) <i>from OR 0 to OR 2</i>. </li> <li> <strong>XGX10</strong> Intrapleural ultraljudsundersökning (<strong>GXDE00</strong> Intrapleural ultrasonography) <i>from OR 2 to OR 1</i>. </li> <li> <strong>XPX30</strong> Endovaskulärt ultraljud (<strong>PXDE1B</strong> Endovascular ultrasonography) <i>from OR 2 to OR 1.</i> </li> </ul><p>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. </p></div></div> <hr/> <p>This case emerged during updates of Swedish primary classifications (see <span class="mention" data-mention="#976"><a class="issue tracker-15 status-5 priority-21 priority-default multieditable-container closed" title="Primary classifications: 2026 updates of NCSP, ICD and ATC (Sweden) (Closed)" onclick="if (!event.metaKey && !event.ctrlKey && event.button === 0) { event.preventDefault(); EasyVue.showModal('issue', 976); return false; }" href="https://nordcaseforum.easyredmine.com/issues/976">#976 - 2026 updates of NCSP, ICD and ...</a></span>) and concerns the OR value of NSCP+ codes KEDE1B <i>Rectal ultrasound examination of prostate </i>in relation to OR value of KEDE1A <i>Percutaneous ultrasound examination of prostate.</i></p><p>The issue was discussed during EG Autumn meeting and it was decided to create a separate ticket for countries to check their data and confirm if they want to keep current OR values of KEDE1B or change it. </p><p><strong>KEDE1A </strong>has OR 0 in all versions.<br>National codes mapped to KEDE1A:<br>•FIN - KE1AE Eturauhasen ultraäänitutkimus<br>•ICE - KEDE1A Percutaneous utlrasound examination fo prostata<br>•LAT - KEDE51 Prostatas Eksterna ultrasonografija<br>•NOR - SKE0AK UL Prostata - ekstern undersøkelse<br>•SWE - AK046 Ultraljudsundersökning, prostata och vesiklar<br>•SWE (new) AK118 Transperineal ultraljudsundersökning av prostata och vesiklar<br>•SWE (new) AK130 Datortomografi, urografi</p><p><strong>KEDE1B </strong>has OR 0 in ICE, FIN and NOR versions, SWE suggest to give OR 2 value to KEDE1B<br>National codes mapped to KEDE1B:<br>•FIN - KE1BE Eturauhasen ultraäänitutkimus peräsuolen kautta<br>•ICE - KEDE1B Rectal ultrasound examination of prostate<br>•NOR - SKE0BK UL Prostata - transluminal undersøkelse<br>•SWE (new) - AK117 Transrektal ultraljudsundersökning av prostata och vesiklar</p><p>The argument to give code <strong>KEDE1B </strong>OR 2 instead of OR 0 was that rectal ultrasound of prostate is generally considered the more demanding procedure than percutaneous ultrasound of prostate.</p><p>Even though the OR values of those two codes were discussed during the meeting, it might be reasonable for countries to have a look and check the OR values of all ultrasound codes.</p><p>It was decided that in 2026PR version, code <strong>KEDE1B </strong>(and respective national codes) will get OR 2 value in SWE version and there is no changes in FIN, ICE and NOR version, i.e. we keep OR 0.</p><p>We will get back to this in 2026 Spring meeting.</p><p> </p>
