Standpoints

V0103J OVERNIGHT HEALTH CARE SERVICES IN THE FRAMEWORK OF THE ZZV-DRG

In the PHR, we have duplication of 2 "types" of codes for some procedures, i.e., a procedure categorized as Category 5 - Therapeutic Surgical Procedures (e.g., 5t790 Excision of ganglioma on hand, significant) and a procedure categorized as Category k - Procedures Reported Only in ICU Reporting (e.g., kt790 Excision of ganglioma on hand, nonsignificant). While rule V0103J states that "Chapter "J" and Chapter "K" procedures are part of the SK-DRG system and are reportable under the SK-DRG," it is not clearly understood what type of procedure the provider should primarily use when coding the JHS KP.

We would like to ask you for clear guidance on which type of performance should be reported in the NHS.

Ensuring consistent and correct reporting of PHC cases where there is duplication of performance.

Chapter K- procedures are combined procedures and are coded if multiple procedures were performed as part of the procedure - as in the past combined or multiple procedures. Chapter K- procedures are undergoing revision and the CKS DRG has an effort to identify specific combinations of procedures that have been reported as combined procedures in the past and currently, so that correct pricing can occur through accurate coding of standard 5- procedures.