Complex medicalnutritonal therapy according to OPS code 8-98j – a unique feature of the German DRG system
- 27.11.2023
- English Articles
- Jasmin Kray
- Robert Renter
- Michael Adolph
- Luzia Valentini
- Jens-Peter Keil
Peer reviewed / Manuscript (original) received: 15. Juni 2022 / Revision accepted: 28. November 2022
Introduction
Nutritional support is the “provision of food or nutrients […] for the purpose of improving or maintaining nutritional status and quality of life and improving clinical outcomes” [1]. The body of evidence shows that implementation of nutritional support in the hospital can positively affect mortality and quality of life, particularly in malnourished patients [2–6]. In international studies, the prevalence of malnutrition according to the criteria of the Global Leadership Initiative on Malnutrition (GLIM) [7] ranges from 23% to 47% depending on the patient population [8–13]. Comparable data was also collected in German hospitals. About 20% of the patients are severely malnourished; another 15% have been diagnosed with moderate malnutrition [14].
Although malnutrition is associated with a longer hospitalization, a higher risk of complications and mortality, and considerable costs [15, 16], screening patients for a risk of malnutrition (far from any treatment approach) on admission has so far not been mandatory in German hospitals. ...
Abstract
Complex therapies belong to the highly specialized forms of therapy, the contents and conditions for implementation of which are defined in the catalog of operation and procedure codes (OPS). The procedure defined since 2019 with OPS code 8-98j describes the complex medical nutritional therapy (CMNT), which requires a specialist-led nutrition team with at least one nutritional therapy specialist (e.g., dietitian or ecotrophologist) as a mandatory structural feature. Process features include screening of nutritional status within the first 48 h of inpatient admission, body composition determinations, and needs assessments for energy and nutrient requirements. In addition, an individual treatment plan is developed and, if necessary, adjusted during follow-ups. CMNT is suitable for all patients who have a differentiated nutritional problem. The clear structure and process features of this therapy reflect internationally required criteria for quality assurance in nutritional therapy. Implementation of this complex therapy with a uniform financial assessment could provide an additional basis for funding nutritionists in nutrition teams and thus increase the presence and acceptance of nutritional medicine and its services.
Keywords: Inpatient nutritional therapy, revenue relevance, malnutrition, hospital, nutrition team, nutritional medicine, nutritional support, complex medical nutritional therapy
