WIESNZ13 cost weights

Summary

The New Zealand Casemix Framework for Publicly Funded Hospitals provides the definitions for inclusion of hospital events in casemix funding together with information related to the calculation of cost weights for these events and the assignment of events to purchase units. WIESNZ13 uses AR-DRG 6.0x which is based on ICD-10-AM 6th Edition codes. A new set of cost weights are provided in the WIESNZ13 weights table.

WIESNZ13 includes the following major changes from the previous year:

  • Six facilities have been retired from the casemix eligible facilities list as they provide no casemix-funded activity. The facilities are: 4212, 5814, 5818, 5819, 5820 and 8303, see 5.2.36 retired facility codes
  • Revised purchase unit mappings for Disability and Health of Older People, see 5.2.6
  • The DRGs E40A Respiratory System Diagnosis W Ventilator Support W Catastrophic CC and E40B Respiratory System Diagnosis W Ventilator Support W/O Catastrophic CC did not have the correct MV designation.  Their designation has been changed from ‘D’ to ‘I’ ineligible, see 4.4.1
  • Adjusted the Radiotherapy exclusion rule to include new XPU assignment, see 5.2.25
  • A new NZ-specific DRG has been developed for O66T SFLP for Twin to Twin Transfusion Syndrome, see 4.3.2
  • A new NZ-specific DRG has been developed for F03M Transcatheter Pulmonary Valve Implant (Melody Valve), see 4.3.2
  • The cost weights apply to the DRG set AR-DRG v6.0x which reinstates 10 DRG complexity splits from AR-DRG v5.0. The 10 reinstated DRGs expanded the 10 DRGs in AR-DRG v6.0 to 20 in AR-DRG v6.0x for maternity, mental health and breast malignancies, see 4.2
  • Revised Primary Maternity wording to allow for developments arising from the new Primary Maternity Service Specifications and revised Purchase Unit structure, see 5.2.16
  • Guidance has been provided for the exceptionally rare cases where the LOS exceeds 365 days, see 4.1.1
  • Adjustment of Medical AR-DRGs with Radiotherapy – updated wording ‘AR-DRG’ to ‘NZ DRG’ and corrected typo on two procedure codes, 1503000 and 1520004.  Correct codes are 1500300 and 1560004, see 4.3.1
  • Publicly Funded Agencies – added ‘1236 Ministry of Health’ to agency table, see 5.2.2.  SAS program updated
  • Identifying DHB Casemix-Funded Events for Inter-DHB Inpatient Flow Calculations – updated wording ‘The Agency Code’ to ‘The Funding Agency Code’, see 5.4
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