DRG Grouping
In order to group one encounter record:
- 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.
- Insert NCSP procedure codes to the Code column of the procedure table. You can also use the Find button to find the correct codes.
- Select the patient gender, age, discharge status and length of stay.
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 press Enter or move the focus elsewhere. You can change the active row by pressing Enter. 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. However, unlike the order of diagnoses, the order of procedures does not affect the resulting DRG. |
| 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. Enter the age in days for newborn care. |
| 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. Diagnostic codes can be searched by code, description, principal diagnosis property, diagnosis category, MDC group, diagnosis property, and / or type. Procedure codes can be searched by code, description, procedure property, diagnosis property, OR property, and / or type. Try entering "A1" to the Code field. As a search phrase you can use full words or parts of a word. When you find the appropriate code, click the row to transfer the code back to the main window.
Using Diagnosis Pairs
VisualDRG Web 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 encounter data. |
| MDC | MDC is the Main Diagnosis Category which can usually be calculated if the principal diagnosis code is provided in the encounter 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 B = Unspecified or impossible |
| Grouping rule ID | The ID of the DRG grouping rule that allows you to go directly to the correct rule on the DRG logic page. Older versions of DRG groupers do not have this information available. |
The DRG, MDC, and Grouping Rule ID result fields can contain links to the DRG Logic page, depending on the license of the application. By clicking on the DRG or rule ID link, the DRG code is searched for and, depending on whether the grouper has returned the rule ID, either the logic rule used in grouping or the first rule in the order of the DRG logic is activated. The MDC link opens a list of DRG codes in that category.
DRG may also have a link to the DRG statistics on the benchmarking page, depending on the license of the application.
Status Information
| Information | Description |
|---|---|
| Used for Grouping | If the input information row (diagnosis, procedure, additional information) has the  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: o OK: diagnosis/procedure code is correct o Error: 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. |