E-Update May 2015
National Collections and Reporting
This E-Update contains articles on the following topics:

3M™ Health Information Systems (HIS) Web Codefinder™ – New Zealand Contract Agreement

National Minimum Dataset (NMDS) Business Objects (BO) Universe

OS10 Measure 3 ‘Standard versus edited diagnosis code descriptors in the National Minimum Dataset
(NMDS)’

Monitoring Clinical Coded Data Reported to the National Minimum Dataset (NMDS)

New Zealand Casemix Framework for Publicly Funded Hospitals 2015/16 – WIESNZ15

End of Financial Year Cut off Dates for National Collections Data
3M™ Health Information Systems (HIS) Web Codefinder™ – New Zealand Contract Agreement
The Ministry has completed the Request for Information (RFI). I’ll keep you updated on progress.
National Minimum Dataset (NMDS) Business Objects (BO) Universe
Last month the two Business Objects universes (NMDS standard and NMDS Encrypted) were updated to
include free text diagnosis and procedure descriptors. This update enables approximately 250 data users who
report on NMDS data from the National Data Warehouse using Business Objects to see and extract the free
text descriptors that have been reported for each diagnosis, external cause and procedure code.
Reminder
Free text is not to be restricted to just the code ranges specified in the OS10 Measure ‘Standard versus edited
diagnosis code descriptors in the National Minimum Dataset (NMDS)’. Free text information should be
reported for all diagnosis, external cause and procedure code descriptors that do not fully translate the medical
statement or circumstances of an injury or accident.
When providing free text information please ensure it is of high quality (meaningful/adding value) as per the
requirements specified in Section 13.11 Quality, standards and completeness of the Operational Policy
Framework, and that the information is appropriate for the code reported. Often when I’m reviewing coded
data the free text information provided is not in context to the code reported, for example, diagnosis
information reported for the external cause descriptor. Data users extract coded data using specific codes
rather than extracting the complete event record, therefore it is important to report free text information that
is in context to the code.
In addition please limit the use of local abbreviations, for example, deleting the entire descriptor and reporting
a number which has no meaning at a national level and reduces the quality of that data to below what it was
with the standard descriptor.
Up to 100 characters can be reported in the diagnosis, external cause and procedure descriptor field therefore
the information reported should be clear, concise and understandable by all users of the data.
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E-Update May 2015
National Collections and Reporting
OS10 Measure 3 ‘Standard versus edited diagnosis code descriptors in the National Minimum
Dataset (NMDS)’
The OS10 measures are indicators of DHB performance. Measure 3 is a data quality indicator of the
documentation recorded in the clinical record. Therefore, clinical coding units should not see this as a measure
of their individual performance, but rather a measure of all disciplines recording information within the clinical
record.
If free text is not reported for the codes specified in Measure 3 then this would indicate that the detailed
information is not recorded in the clinical record. This highlights a documentation issue.
Earlier this year many DHB coding units expressed an interest in wanting to improve their rating on the
quarterly reports for Measure 3. Following this it was decided that Data Management National Collections
Team would provide a monthly report to any DHB that was interested in receiving one. Notification was sent
out on Monday 2 February 2015.
The report is DHB specific, it shows what descriptors are counted as part of Measure 3 and includes the current
percentage rating as at the date the report is generated. 15 DHBs requested and have been receiving this
monthly report.
Due to the increased awareness of the types of descriptors counted as part of Measure 3 it is clear from the
data reported that some DHBs are changing or adding text in order to increase their ratings rather than
focussing on translating the medical statement and providing the specificity where available. See examples
below.
Code
Reported Descriptors
ECL Descriptors
M05.91
M79.70
Seropositive rheumatoid arthritis, unspecified,
in shoulder region
Fibromyalgia of mult sites
Seropositive rheumatoid arthritis, unspecified,
shoulder region
Fibromyalgia, multiple sites
W22
Striking against or object
Striking against or struck by other objects
Y92.09
Other and unspecified place at home
Other and unspecified place in home
Hospital
Health service area
HSA
Health service area
Y92.22
This month the Ministry completed a review of the free text descriptors reported for the code ranges specified
in Measure 3. Following this review the algorithm for Measure 3 was revised. Therefore, DHBs may see a
slight decrease in their percentage ratings on the monthly reports if the free text reported is similar to the
examples provided above.
The Ministry will continue to monitor the free text descriptors reported which may result in further revisions of
the algorithm.
If you are not currently receiving the monthly report generated by Data Management National Collections and
wish to, please contact Naomi Ashworth – Data Quality Analyst by Email: operations@moh.govt.nz
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E-Update May 2015
National Collections and Reporting
Monitoring Clinical Coded Data Reported to the National Minimum Dataset (NMDS)
Over the last six months I’ve been monitoring and reviewing clinical coded data reported to the NMDS.
All coded data monitored and reviewed has been from the implementation of 8th Edition (1 July 2014) to the
current day the report was processed.
Many DHBs have been requested to review, correct and re-submit event records to the NMDS. If your DHB has
not received any requests this means no coding or data issues were found.
Listed below are some of the specific areas reviewed to date:
 Z38.0 Singleton, born in hospital reported with an inpatient (IP) event type. Should be BT (birth) event type
or Z38.0 is an incorrect code assignment
 Event type for birth (BT) reported without one of the codes Z38.0 Singleton, born in hospital , Z38.3 Twin,
born in hospital , Z38.6 Other multiple, born in hospital reported
 Systemic inflammatory response syndrome (SIRS) (R65.0, R65.1, R65.2, R65.3) reported as principal
diagnosis when it shouldn’t be, as per ACS 0110 Sepsis, severe sepsis and septic shock
 Septic shock (R57.2) reported as principal diagnosis when it shouldn’t be, as per ACS 0110 Sepsis, severe
sepsis and septic shock
 Carrier of viral hepatitis (Z22.51, Z22.52, Z22.59) reported when it shouldn’t be, as per ACS 0104 Viral
hepatitis
 Z48.8 Other specified surgical follow-up care reported as principal diagnosis with Z39.0- Postpartum care
and examination immediately after delivery as secondary diagnosis. See ACS 1519 Delivery prior to
admission
 D63* Anaemia in chronic diseases classified elsewhere reported as principal diagnosis where neoplasm or
chronic kidney disease is reported as a secondary diagnosis. D63* can only be assigned when the anaemia
is linked to a chronic disease listed in the ICD-10-AM Alphabetic index
 Principal diagnosis has condition onset flag value of 1. See ACS 0048 Condition onset flag – point 3,
exceptions are point 4 neonates and 5 combination codes
 Z58.7 Exposure to tobacco smoke I reviewed the free text reported. See New Zealand Convention click here
 Thrombolysis procedure for stroke management. Reviewed stroke data to ensure thrombolysis procedure
was not coded as per ACS 0042 Procedure normally not coded – point 8 drug treatment/pharmacotherapy
 Z45.82 Adjustment and management of peritoneal access device. Reviewed code Z45.82 to ensure it is not
assigned for removal of Tenckhoff (CAPD) catheters. ICD-10-AM Alphabetic index revised in 8th Edition,
code assigned should be Z49.0 Preparatory care for dialysis
 Procedure code 96199-00 [1920] Intravenous administration of pharmacological agent, antineoplastic
agent. Reviewed procedure code to ensure it is assigned for neoplasm conditions only
 Procedure code 92204-00 [1866] Noninvasive diagnostic tests, measures or investigations, not elsewhere
classified. Reviewed free text information where specified as synacthen stimulation test. ACHI index
revised, new code created in 8th Edition for synacthen stimulation test 30097-00 [1858] Adrenocorticotropic
hormone stimulation test
 Prophylactic surgery (Z40.00, Z40.01, Z40.08, Z40.8, Z40.9). Reviewed code assignment and sequencing
with procedure codes. See ACS 2114 Prophylactic surgery
 J09 Influenza due to certain identified influenza virus. Reviewed free text reported to ensure there were no
cases of H3N2. Influenza A H3N2 should be assigned code from J10.-. See published Q&A June 2012.
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E-Update May 2015
National Collections and Reporting
The monitoring and reviewing of NMDS coded data is an ongoing process, therefore DHBs may receive regular
requests to review, correct and re-submit event records to the NMDS where appropriate.
New Zealand Casemix Framework for Publicly Funded Hospitals 2015/16 – WIESNZ15
Unit Price
The unit price for WIESNZ15 has not been confirmed yet for the financial year 2015/16. Once it has been
confirmed I’ll send out a notification and update the WIESNZ15 Casemix Framework Document.
End of Financial Year Cut off Dates for National Collections Data
End of year 2014/15 reporting and wash-up deadlines for National Collections data are:
National Non-Admitted Patient Collection (NNPAC) Inter District Flow (IDF) Data
 DHBs to submit 2014/15 NNPAC data to the Ministry by midday Friday 31 July 2015 for inclusion in the
2014/15 wash up
 A separate extract will be run for IDF forecasting (as in 2014), with DHBs required to submit data by midday
Friday 28 August 2015
If your DHB is planning to clean up NNPAC data that are already loaded (deleting and re-loading event records)
please contact Richard Lee (operations@moh.govt.nz) so Data Management National Collections can ensure
resources are available for processing the additional files.
National Minimum Dataset (NMDS) Inter District Flow (IDF) Data
 DHBs are encouraged to submit their 2014/15 NMDS data to the Ministry by Friday 31 July 2015
 IDF inpatient wash-ups will be run on Monday 3 August 2015 and the results finalised by Friday 28 August
2015
Electives Data (in NNPAC and NMDS)
 The final electives data submission is Friday 31 July 2015
If you have any queries or believe your organisation won't be able to meet these deadlines, or you need help to
prioritise event records to reduce the impact of missing data on the IDF and Elective processes, please contact
Angela Pidd, Manager, Data Management National Collections by Email: operations@moh.govt.nz
Please contact the coding_helpdesk@moh.govt.nz if you have any questions about the content in this EUpdate.
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