The Operation and Procedure Code (OPS) is used to code operations and medical procedures in inpatient care as well as outpatient surgery in the clinic.
Together with the disease-related codes from the ICD-10 catalogue and individual patient data, they represent the essential components for the evaluation of a flat rate per case (aG-DRG).
Worth knowing about OPS
An operation and procedure key is a code that enables the documentation of a certain encodable treatment option in the hospital. Treatment options can consist of surgical, diagnostic, imaging or surgical procedures as well as the administration of drug substances.
1 – Diagnostic measures
3 – Diagnostic imaging
5 – Operations
6 – Medicines
8 – Non-operative therapeutic measures
9 – Complementary measures
The numbering of the chapters has gaps due to historical development.
The application procedure is opened at the beginning of December each year. The deadline for submission is always the last day of February of the following year (in leap years this is 29.02.)
Who needs an OPS code and why?
Surgery and procedure codes are used to document the medical measures taken in a hospital case. This documentation serves a wide range of requirements, which can be found not only in economics, but also in quality assurance, transparency, statistics, science and epidemiology.
Since the introduction of the G-DRG, the annual modification of the OPS classification is mainly carried out in order to comply with the flat-rate payment systems. Thus, in addition to the other requirements mentioned, the main focus is on accounting purposes.
Operation and procedure keys can influence the classification in a G-DRG and thus become economically relevant. Additional charges are also usually triggered by the documentation of an OPS.
The documentation of OPS codes by the service providers enables the measurement of Usecases as well as a case- or DRG-related cost assignment. This data is relevant, among other things, for the adjustment of DRG information with regard to relative weight points. A complete documentation or use of existing OPS codes is of highest relevance.
Who may submit an OPS amendment proposal to BfArM?
OPS proposals are primarily to be submitted by the professional associations responsible for the content. Thus, a professional evaluation and bundling of the proposals can be realised, which causes an identification of relevant proposals and thus contributes to the acceleration of the processing.
Individuals as well as submitting professional associations are asked to coordinate their proposals in advance with all or all other professional associations relevant to the proposal. BfArM initiates this coordination process for proposals which have not been coordinated with the relevant professional associations.
This coordination process initiated by BfArM may not be completed during the ongoing proposal procedure, so that the proposal cannot be implemented.
Proposals concerning external quality assurance must be coordinated with the responsible organisation (IQTiG).