慢性阻塞性肺疾病ICD-10编码探讨

The Discussion on ICD-10 Coding of Chronic Obstructive Pulmonary Disease

慢性阻塞性肺疾病涉及了慢性支气管炎、肺气肿和慢性支气管哮喘一大类疾病。医师在病案首页中往往将涉及的几个诊断分开书写,编码员通常是从计算机中直接对应这些诊断分别查找编码,从而忽略了ICD的合并编码原则导致编码错误。ICD-10类目J44是慢性阻塞性肺疾病的编码,明确规定包括:慢性支气管炎、阻塞性肺气肿等情况,是下呼吸道疾病发展较深(重)的一组聚类的疾病编码。如果把肺气肿等分开编码则不能体现慢性阻塞性肺疾病的状况。因此对慢性阻塞性肺疾病编码时必须遵照编码原则,不能对ICD明确规定其包括的各个疾病分别进行编码。

Chronic obstructive pulmonary disease （COPD） concerns a series of diseases like chronic bronchitis, emphysema and chronic bronchial asthma and etc. Physicians often separately write down these diagnoses. The coders usually look up the coding individually with ignoring the principle of combination coding that leads to error coding. Category J44 is the coding of COPD which dearly regulates chronic bronchitis and obstructive emphy- sema that are group of disease coding of deep development of lower respiratory tract. If emphysema and etc are separately coded that can not embody the situation of COPD. Therefore, COPD coding should follow the coding principles without separately coding the disease regulating by ICD.