肾小球疾病编码思路

Thinking of Coding of Glomerular Diseases

肾小球疾病编码首先要区分其为原发性、继发性还是遗传性。原发性肾小球疾病分类于N00-N06,遗传性肾病分类于N07;再根据有无病理和病理类型从.0-.9中确定亚目:无病理者编.9;有病理者若病理类型有专门亚目,编.0-.7,无专门亚目者,编.8。继发性者要在第十四章之外的章节中选择原发病的编码,通常是剑号码;所继发的肾小球病变编入星号类目N08*的相应亚目,但继发性的病理类型不在编码中体现。在肾小球疾病的相关概念中,有些有广义与狭义之分,如"肾病"与"肾炎";有些定义不很明确,如"特发性血尿"和"孤立性蛋白尿";有些容易被混淆,如"系膜增生性"与"膜增生性"。弄清楚这些概念,对于正确编码思路的形成从而提高编码的准确性具有重要作用。

Glomerular disease coding must first distinguish it as a primary, secondary, or inherited. The primary glomerular diseases should be designated to one of the categories N00 to N06 and the hereditary nephropathy be coded to the category N07; then, assign subcategory from .0 to .9 according to whether having pathologic material and the pathologic patterns： code .9 for those not having pathologic material, .0 to .7 for those having pathologic material, if there is a special subcategory correspond to the pathologic pattern, code .8 for no corresponding subcategory. For the secondary, a code from chapters except Chapter 14 should be chosen for the primary disease, and it’s usually a dagger code; for the secondary lesion in glomeruli, code to relevant subcategory in the asterisk category N08＊, but the secondary pathologic pattern don’t need to be reflected in the code. In the relevant concepts about glomerular diseases,some have difference of broad and narrow sense, e.g.,“nephropathy”,“nephrosis”and“nephritis”;some haven’t been defined clearly, e.g.,“idiopathic hematuria”and“isolated proteinuria”; some are likely to be confused,e.g.,“mesangial proliferative”and“membranoproliferative”. To make clear these concepts is important for forming a correct line of thinking and then improving accuracy of coding.