摘要
目的加强同行交流,提高编码准确性。方法在ICD-10的使用过程中,容易忽略疾病的病因而造成编码错误。本文针对三例疾病名称中含有英文的综合征进行编码剖析,强调明确病因编码的重要性。结果当有明确病因时,一般要首先考虑病因作为主要分类依据。结论正确选择疾病编码,关键要熟悉ICD-10的分类原则、方法、步骤及分类轴心,尤其对于含有英文的疾病名称,更要细查引起该病的病因、临床表现,甚至相关手术处理、治疗方式,才能确保编码的准确性。
Objective To strengthen the communication between the peers and improve the coding accuracy.Methods In the process of using ICD- 10,coding errors become easy because of overlooking the etiology of the disease. Analyzing three cases named " disease" and " syndrome" in English in this paper to emphasize the importance of clear cause code. Results When there is a clear cause,we should consider the cause as the main basis for classification firstly. Conclusion To choose the correct disease coding,we should be familiar with ICD- 10 classification principles,methods,steps and classification of the axis. Especially for which named " disease" and " syndrome" in English,we must examine the cause,the clinical manifestations of the disease,and even related operation treatment,treatment methods,in order to ensure the accuracy of the code.
出处
《现代医院》
2015年第10期134-135,139,共3页
Modern Hospitals
基金
深圳市卫生计生系统科研项目(编号:201401047)