Cn 2017 NCAMP NMDS WIESNZ17 V0.2

Change Notification: cn_2017_NCAMP_NMDS_WIESNZ17_v0.2 Date of Issue: 4 November 2016

Subject: Implementation of 2017/18 New Zealand Casemix Framework for Publicly Funded Hospitals Weighted Proposed Implementation Date: 1 July 2017 Inlier Equivalent Separations (WIESNZ17) methodology and casemix purchase unit allocation CHANGE NOTIFICATION Summary: This change notification informs the sector that the Ministry will implement the 2017/18 New Zealand Casemix Framework for Publicly Funded Hospitals (WIESNZ17) developed by the Casemix Project Group for NMDS event records with an event end date on or after 1 July 2017. National Collections Impacted by Change: NMDS Context of the Change: WIESNZ is the methodology used to calculate the Cost Weight value based on the assigned Australian Refined Diagnosis Related Groups (AR-DRGs) and New Zealand costs. Revisions and implementation of WIESNZ are performed annually as part of the National Costing Collection Programme (NCCP) and NCAMP. The AR-DRG upgrade to version 7.0 is one of the factors contributing to the WIES review for 2017/18. What is Expected of the Sector: The Ministry will provide 3M HIS with the 2017/18 Casemix Framework document so the methodology and weight schedule for WIESNZ17 can be developed into the 3M Codefinder application. DHBs that have their own grouping/costweight systems/applications will need to update these to reflect the changes in the 2017/18 Casemix Framework document (WIESNZ17). Otherwise there are no expected changes for the sector. Details of Proposed Change: The New Zealand Casemix Framework for Publicly Funded Hospitals 2017/18 will be available on the NCAMP website www.health.govt.nz/ncamp at the end of November 2016. WIESNZ17 is based on ICD-10-AM/ACHI 8th Edition and AR-DRG v7.0. This is a change from WIESNZ16 which was based on ICD-10-AM/ACHI 6th Edition (after event records coded in 8th Edition had their codes back mapped to ICD-10-AM/ACHI 6th Edition) and AR-DRG v6.0x. The framework associated with WIESNZ17 is the same as WIESNZ16 except for the following:  ICD-10-AM/ACHI diagnosis and procedure codes including descriptors have been updated to 8th Edition  DRGs and descriptors have been updated to AR-DRG v7.0  Radiotherapy mapping for medical DRGs has been maintained however events map to a new NZ specific DRG R64W Radiotherapy  Revised DRGs excluded from mechanical ventilation days  NZ specific DRG A39W now includes only pelvic exenteration events, with an expanded definition to include male events  ASD co-payment value has been revised  Scoliosis co-payment rule has been revised to include paediatric events provided at Counties

Date of Issue: 4 November 2016 cn_2017_NCAMP_NMDS_WIESNZ17_v0.2 Page 1 of 2 Manukau and Waikato DHBs. Co-payment value has been revised  EPS co-payment rule has been revised to include the procedure code 3851800 [609] to allow for ventricular ablation  The live donor nephrectomy co-payment now only applies to DRG L04B. The co-payment value has been revised  Endovascular treatment for cerebral aneurysm co-payment has been revised to include clot retrieval procedures for strokes. The co-payment value has been revised  A new co-payment has been developed for the isolated limb infusions procedure (ILI)  Due to the new structure of the neonatal MDC in AR-DRG v7.0 well newborn and neonate definitions have been revised  The primary maternity RVUs have been revised  Scope exclusion rules for cystoscopy, bronchoscopy, ERCP, colonoscopy, and gastroscopy have been revised which has led to a small number of newly excluded events. Impact of Change on National Collection(s): As the Ministry are the official calculators of the Diagnosis Related Groups (DRGs) and caseweights the NMDS will be updated to calculate caseweights, NZ-DRGs and excluded purchase units. The 2017/18 Casemix Framework will be available for NMDS event records with an event end date on or after 1 July 2017. Comments:

Contact: If you have any questions regarding this change notice, please email [email protected] or contact Ron Wood (Project Manager) on 04 816 3352.

Date of Issue: 4 November 2016 cn_2017_NCAMP_NMDS_WIESNZ17_v0.2 Page 2 of 2