Vo vysvetlivkách Prílohy č.13 sa MS určuje podľa poradia riadkov vyhlášky, t.j. od 1. určeného výkonu vo vyhláške po posledný určený výkon vo vyhláške. Poradie výkonov ale nie je zoradené podľa náročnosti výkonu. Nákladovo náročnejšie výkony sú nižšie v poradí, ako menej nákladové.
Read moreOrganisation: SÚSCCH, a.s.
Created at: 23.07.2025 14:57:25
Area
Medical services
Subarea
Parameter change - name, method of determination, level and MS obligation
Question
The Grouper vendor has configured a check for the "complexity" of DRG procedures according to Appendix No. 13 (MS based on the primary procedure) for HP, whenever multiple procedures from Appendix No. 13 are coded —it refers to the explanatory notes below the appendix, where the order of procedures in the appendix is specified. We believe that the order is not based on complexity/cost, because, for example, 1k213.- is not more complex than 8r8p0.- or 8r8ph.-, yet it appears higher in the order...Similarly, 323. is higher in the order but is less complex than 8r8. (except for the localization of an intracranial vessel)...Similarly, 1k130.- and 1k211.9 are less costly than 5k7.- and 8r861.-, yet they are ranked higher. Is this configuration by the supplier correct? Are the procedures in Appendix No. 13 ranked according to complexity?
Answer
Case Handled Through the CKS DRG System