Summary:
Review workers of the Review Office for Surgical Fields of the General Health Insurance Company (GHIC) of the Czech
Republic for Prague follow systematically the development of endoscopic operations in Prague and relatedly analyze reporting
and refunding of this type of health care by the General Health Insurance Company.
The paper presents the review of reported laparoscopic operations in surgical specialties and the development of operations
from 1999 to 2001 and related changes in reporting and refunding the procedure No. 51711 including reported DRG markers
and Extra charged material are compared. At the same time, the procedure of physicians reviewers related to the analysis
of all available data from the Information Centre of the GHIC and their comparison with the data from medical documentation
in the health facility is described.
Factual negotiations during controls and comparing the reported procedure No. 51711 and Extra charged material to records
from medical documentation is considered the contribution with the possibility of checking mistakes because reporting and
refunding of reported procedures is not correct in 70% health facilities which contracted the procedure No. 51711.
Key words:
code No. 51711 – laparoscopic and thoracoscopic procedure – DRG markers – Extra charged material subgroup
No. 82 – Code book of GHIC – analysis from IC GHIC – review – mistakes in reporting
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