Malle Avarsoo
EST version should have the change too. Clinically valid proposal for change, as all other C44 dgn code are having MDC 09.
Kristiina Kahur
Edited
Nordic Casemix Centre/Kristiina Kahur 6-2-2025
ICD-10 codes referring to "skin of XX" belong mostly to MDC09. The exemptions to this rule are the ICD-10 plus codes mentioned in the proposal:
C4410 Malignant neoplasm of skin of eyelid, including canthus (used in all versions)
C441A Basal cell carcinoma of skin of eyelid, including canthus (used in SWE and FIN version)
C441B Squamous cell carcinoma of skin of eyelid, including canthus (used in SWE and FIN version)
In addition, there are two codes belonging to MDC02 and used in all versions:
D0410/D041 Carcinoma in situ of skin of eyelid, including canthus
D2310/D231 Benign neoplasm of skin of eyelid, including canthus
I would recommend to consider the change of MDC (and other grouping features) from 02 to 09 of codes D0410 and D2310 as well (if cost data support) to make it consistent among the dg codes concerning skin of certain anatomical area.
Kristiina Kahur
Nordic Casemix Centre/Kristiina Kahur 16-2-2026
Countries considering this change should pay attention to eye procedures the above mentioned diagnosis codes can be related to. After the change of MDC02 -> MDC09 of dg codes, the proc codes which do not have MDC09 PROCRP in combination with those dg codes may end up in DRG 477/O.
E.g. C441/C4410 in combination with CBSJ40 will be grouped to DRG 477.
Countries are recommended to check eye procedures without MDC09 PROCPR (09S02 Plastic procedure or 09S07 Other skin, subcutaneous tissue or breast procedure are the mainly used ones) which can be performed in case the main dg is C441 (and D041 and D231) and consider adding PROCPR 09SXX to the eye procedures.
Lotta Sokka
Finland finds the change logical and supports it. For Finland the change concerns the following dg codes:
· C4410 Silmäluomen tai silmäkulman ihosyöpä ei histologista vahvistusta
· C4411 Silmäluomen tai silmäkulman tyvisolusyöpä
· C4412 Silmäluomen tai silmäkulman okasolusyöpä
· C4419 Silmäluomen tai silmäkulman ihosyöpä muu tai epämääräinen histologia
· D041 Silmäluomen tai silmäkulman ihon pintasyöpä
· D231 Silmäluomen tai silmäkulman ihon hyvänlaatuinen kasvain
During our analysis we found certain similar proc codes which have not been given MDC 09 PROCPRs and we want to add them to those to avoid certain cases to group to DRGs 477/4770.
Techincal changes for the change of PROCPRs (TC_995_C44_D231_D041_change_of_MDC_and_PROCPR_FIN.xlsx) can be found in in the appendix.
- Attachment TC_995_C44_D231_D041_change_of_MDC_and_PROCPR_FIN.xlsx added
Asa Wresros
Sweden have updated our TC with som small changes, se attached file.
- Attachment TC_C1065 Ändra MDC på C441 utökad.xlsx v1 added
Birna Björg Másdóttir
Iceland also agrees on this change.
Kristīne Putniņa
Latvia agrees with the changes, because in essence the diagnoses C441, D04.1, D23.1 correspond to skin problems. When looking at the costs, for example, the cases of diagnosis C44.1 are closer to other cases of diagnosis C44 than to cases of MDC02. When checking Kristiina's recommendation, I did not get group 477 by combining C441, D041, D231 with proc CBJ40 (contains procprop 09s02 or procpr 09S07), proc CBB30, CBB99, as well as QBC00 (procpr 09s08) for testing purposes. Accordingly, I got DRG 040 or DRG 047. I hope I understand correctly Kristiinas recommendation. Therefore, I ask that only the change of mdc for three diagnoses be applied to Latvia. TC attached to this case.
- Attachment TC_995_dg_mdc2 to mdc9_LAT.xlsb added
Kristiina Kahur
2026-03-10 Expert group
This change will be done as follows:
EST, FIN, ICE, LAT, SWE version - according to original suggestion+ modified suggestion concerning additional dg codes D0410/D041 and D2310/D231 and adding MDC09 PROCPRs to eye procedures (based on countries' TCs).
NOR - needs more time for analysis.
Kristiina Kahur
- Status changed from Active to Further active
Asa Wresros
Attached is Swedens updated TC with additional dg codes D0410/D041 and D2310/D231.
- Attachment TC_C1065 Ändra MDC på C441 utökad.xlsx v2 added
Asa Wresros
- Subject changed from Change MDC on IDC-code C44.1 to Change MDC on ICD-code C44.1
Kristiina Kahur
Nordic Casemix Centre/Kristiina Kahur 30-3-2026
This change is now done in NDMS in all versions except Norway.
The changes concerning the dg codes were made the same way in all versions based on national codes mapped to plus codes C4410, C441A, C441B, D2310 and D0410, i.e. all MDC02 features (MDC, DGCAT and SDGPRO) were changed to MDC09 respective features. Other grouping features remained unchanged.
In addition, in SWE versions, the changes were made in logic table as suggested.
When it comes to changes in PROCPRs, the changes in SWE version were made as suggested in the latest TCs. In other versions the changes were done as suggested by Finland.
A summary of the changes is attached. Please double-check and if any need for corrections please inform us asap (within a week) so that we can make the corrections in NDMS before delivery of 2027PL0 tables.
As agreed, we keep this case further active for Norway to conduct an analysis.
- Attachment #995_TC_NDMS_EST,FIN,ICE,LAT,SWE.xlsx added