Povinné vs. nepovinné lokalizácie zdravotných výkonov

Organisation: NUSCH a.s.

Created at: 30.03.2026

Processed at: 07.04.2026

Question

At the beginning of 2026, the ZP Trust set up new automatic corrections to reject classification cases on the basis of "incorrectly determined location". In these cases, the location of the procedure was determined correctly, but the ZP Trust requires an undetermined location (Z) for these procedures.

These are mainly procedures 5k785.- / 5k786.-, which, according to the ZP Trust, must not have a reported location, on the contrary, procedures from the group 8z00- may have it.
Performances from group 5l570.- must also not have localization reported.

At the same time, there are questionable procedures that are also DRG PP 8r8x1.- where we have denied all HPs where localization is indicated for that procedure.

As these are DRG procedures where there is no obligation under the Coding Rules and the Definitions Manual to determine localization, I feel that control beyond the rules under the Coding Rules is inadequate and can be considered chicanery.

I am asking for guidance from health insurers and healthcare providers on the question: for which medical procedures must localization not be specified? Clear definition of which medical procedures must / may / must not show laterality.

Answer

Due to recurrent disputes in the determination of laterality of diagnoses and medical procedures, the CKS DRG proceeded to determine the initial draft of the need for coding laterality of entire codes of diagnoses and medical procedures. That proposal is currently being commented on by the Medical Analysis Working Group and will be published by the CKS DRG once the final settings have been determined, and you will be notified of its publication via the CKS DRG Update. It is agreed that the determination of the laterality coding obligation from 2027 onwards will be part of the ZZV and MKCH codes, where their settings will be subject to regular updates based on feedback from users of the classification system.