Prodacapo VisualDRG Web Release

User's Guide

Contents

Overview.. 1

How does it work?. 1

Functionality. 1

Usage. 1

DRG Grouping. 1

Search Functions. 1

Using Diagnosis Pairs. 1

Grouping Results. 1

Function buttons. 1

Status Information. 1

Using weight tables. 1

 

Overview

How does it work?

Prodacapo VisualDRG Web Release (EVDRGWR) is a Web application for interactive DRG grouping and analyzing DRG grouping results. Using EVDRGWR you can enter the patient information for the grouper, browse and search diagnosis and procedure codes and see how they affect the grouping.

Grouping patient records with EVDRGWR is done in the following way:

1.    Enter data (diagnoses, procedures and other information).

2.    Press the Group button.

3.    Check the DRG grouping results.

After grouping a patient record you can click the link in the MDC field to open the NordDRG Manual. The manual shows more information about the MDC/DRG grouping logic.

Functionality

The software product includes the following functionalities:

·         DRG grouping based on a patient record

·         Support for multiple NordDRG grouper versions (from different years)

·         Additional (grouper version based) information: DRG weights, limits etc.

·         Status information: which part of the information had affect in choosing the DRG

·         Text and code based search functions for diagnosis and procedure codes

·         Direct links to NordDRG manual for analyzing the grouping logic

Usage

DRG Grouping

In order to group one patient record:

1.    Insert one or more ICD-10 diagnosis codes to the Code column of the diagnosis table. You can also use the Find button to find the correct codes.

2.    Insert NCSP procedure codes to the Code column of the procedure table. You can also use the Find button to find the correct codes.

3.    Select the patient gender, age, discharge status and length of stay.

4.    Press the Group button.

The following table presents the input fields in more detail:

Field

Description

Diagnoses

Diagnosis codes can be entered directly on the Code column, e.g. try entering "O800" and clicking the Group button. You can change the active row by pressing TAB. Alternatively you can use search functions which open by clicking the Find button.

 

Clicking the Main diagnosis button swaps the selected diagnosis and the main diagnosis and the case is regrouped immediately. At least one main diagnosis must be entered.

Procedures

These fields work exactly the same way as the diagnosis fields. The order of procedures, in contrast to the order of diagnoses, does not affect the resulting DRG, however.

Gender

The Gender selection has the following options: male, female or missing data (unknown or erroneous data).

Age

Enter the patient's age in years or days if this information is available.

Discharge status

Only few listed discharge statuses codes affect the DRG grouping. If none matches your data, select "End of treatment".

Length of stay

Enter the length of stay in days. If the actual length of stay is over 999, it is irrelevant for grouping. In this case, enter “999”.

Search Functions

You can search diagnosis and procedure codes by clicking the Find button. The codes can be searched based on the code and/or the description. Try entering "A1" to the Code field and clicking the Find button or pressing the Enter key. As a search phrase you can use full words or parts of a word. When you find the appropriate code, click the Select button to transfer the code back to the main window.

Using Diagnosis Pairs

Prodacapo VisualDRG Web Release uses the diagnosis pair information exactly the same way as described in the NordDRG manual. It is important to distinguish between two separately given diagnoses (principal diagnosis and secondary diagnosis) and one diagnosis pair that contains two codes: the symptom and the etiology. A code marked with an asterisk (*) represents the symptoms or manifestations of a disease. These codes are not used alone when classifying according to the ICD. A second code, marked with a dagger (+) indicating the etiology of the disease is needed. The two codes define one diagnosis. 

When entering pairs the codes must be given by using format: "symptom code*etiology code". Try entering "M073*L405" to the code column of the diagnosis table.

Grouping Results

The following table describes the grouping result fields:

Result Field

Description

DRG

This is the main result from the grouping process, the DRG code for the current patient data.

MDC

MDC is the Main Diagnosis Category which can usually be calculated if the principal diagnosis code is provided in the patient record data. The grouping logic is described in the NordDRG Manual.

Return code

The Return Code includes information on how the grouping process was executed and will also reveal possible errors during the process. The possible codes are:

·         0 = Grouping completed technically

·         1 = No principal diagnosis

·         2 = Gender of the patient is missing

·         3 = Gender of the patient is incoherent with the diagnosis

·         4 = Patient is too young for current diagnosis

·         5 = Patient is too old for current diagnosis

·         6 = Error in the age of the patient (>125)

·         7 = Rare or false combination of diagnosis and procedure

·         8 = Principal diagnosis not applicable

·         9 = Other error

·         A = OR procedure for hemangioma

Function buttons

This is the list of other buttons and how they are used in the VisualDRG WR main window:

Button or link

Description

Find

Opens a search window for diagnoses or procedures.

Main diagnosis

Swaps the selected diagnosis and the main diagnosis.

Group

After entering patient information, the Group button runs the DRG grouping.

Reset

Clears all information on the form.

Print

Opens the Print dialog of the browser. If you want to preview the page before printing, open the print preview in browser menu.

Help

Opens this User’s Guide.

NordDRG Manual

Opens the NordDRG Manual.

Status Information

Information

Description

Used for Grouping

If the input information row (diagnosis, procedure, additional information) has the http://msdev/EVDRGWR/Images/EcomedOne/ok_24.png symbol in the Used for grouping column, that information has had an effect on the resulting DRG group.

Status

Possible values of the Status column:

·         http://msdev/EVDRGWR/Images/EcomedOne/ok_24.png: diagnosis/procedure code is correct

·         http://msdev/EVDRGWR/Images/EcomedOne/error_24.png: diagnosis/procedure code is not valid

o   External cause as a primary diagnosis

o   Manifestation diagnosis as an etiological diagnosis

o   ATC code as a manifestation diagnosis

o   ATC code without a manifestation diagnosis

o   Manifestation diagnosis without an etiological diagnosis

CC status

Some DRGs have variants for cases with and without complications. A secondary diagnosis has affected the selection of the group with complication and comorbidities if the CC status column contains the symbol CC. If the CC status column contains the symbol MCC, a secondary diagnosis has affected the selection of the group with major complication and comorbidities. Note that CC Status major complication and comorbidities is used only with NordDRG CC groupers.

OR property

Procedures can have a so called OR property. If the column has the value "Surgical", the procedure has been defined as a surgical operation to be performed in an operating room.

Using weight tables

You can select DRG weight table for active DRG version. Each weight table has its own default base rate, but You can also set custom base rate. VisualDRG Web Release will remember last used DRG weight table and custom base rate for it by each user. You can reset user specific base rate back to default with reset button.

The following table describes the DRG weight table related result fields:

Field

Description

DRG weight

This field contains the relative DRG weight for the resulting DRG derived from the active DRG weight table. Relative weight measures the relative average actual cost. Weight 1,0 stands for an average patient what comes to expenses and weight 1,500 means a 50% more expensive patient cases on the average based on the selected weight table.

Revenue

Revenue is calculated by DRG weight and cost limits.

LOS limits

Min – Max [days]
Some DRG weight tables or DRG revenue systems may include limiting values for the actual length of stay of the patient. If the length of stay is less than the lower limit specified or greater than the upper limit specified the case is interpreted as a DRG outlier case and charged based on actual cost. Depending on Your DRG weight table you may have either LOS limits or cost limits with either just upper limits or they may include both upper and lower limits.

Cost limits

Min – Max [money]
Outlier limits for the actual cost of the patient cases interpreted in the same way as LOS limits.