心脏起搏装置植入相关编码分析

Analysis of Coding Related to Implantation of Cardiac Pacing Device

通过文献阅读,结合ICD编码工作,总结归纳心脏起搏装置的类型、植入后并发症及相关手术术式分类,为编码员准确编码提供参考。对于疾病编码,主要考虑首次入院目的、植入后并发症情况(T编码+损伤原因编码)以及起搏器电池耗竭问题(Z45.0)。对于手术编码,关键在于手术目的及起搏器植入或修复类型:永久性单腔/双腔起搏器(有无节律反应)植入(或置换),编码分类于37.8,需另编码37.70~37.77;埋藏式心脏转复除颤器(ICD)无论经静脉ICD还是皮下ICD,均分类于37.94;心脏再同步化治疗CRT-P分类于00.50,CRT-D分类于00.51;临时性心脏起搏器植入分类于37.78;起搏器的部分修复,分类于37.7和37.8。心脏起搏装置的相关疾病与手术编码,因疾病诊断的不同以及手术方式的差异而有所区别。编码员只有熟练掌握心脏起搏装置的类型、术式及所对应的适应症,准确把握编码规则,才能做到编码准确。

Implantation of cardiac pacing device is one of the common surgical methods to treat Arrhythmia and cardiac dysfunction.Based on literature review and ICD coding,this paper summarizes the types of cardiac pacing devices,post-implantation complications and the classification of related surgical procedures.For the disease coding,the first admission goal,post-implantation complications(T code+cause of injury code)and Pacemaker Battery Depletion were considered(Z45.0).For the surgical coding,the key lies in the objective of the surgery and the type of pacemaker implantation or repair:Permanent single chamber/double chamber pacemaker(with or without rhythmic response)implantation(or replacement),coding 37.8,additional coding 37.70-37.77;Implantable cardioverter defibrillator(ICD)was classified as 37.94,transvenous or subcutaneous ICD;Cardiac resynchronization therapy(CRT-P)was classified as 00.50,CRT-D was classified as 00.51;temporary artificial pacemaker implantation was classified as 37.78;Partial repair of pacemakers,categories 37.7 and 37.8.The related diseases and operation codes of cardiac pacing devices are different due to different disease diagnosis and operation methods.Only when the coders skillfully master the types,operation methods and corresponding indications of cardiac pacing devices,and accurately grasp the coding rules,can the coding be accurate.