医疗性终止妊娠编码分类规则的探讨

Discussion of Coding Classification Rules for Medical Termination of Pregnancy in ICD-10

从我国目前在O00~O08流产结局的妊娠一节编码应用中存在的主要问题出发,阐述O04医疗性流产概念的实际涵义是医疗性终止妊娠。而对于医疗性终止妊娠主要诊断选择存在的困惑,通过举例说明澳大利亚的具体编码步骤,参考其国家编码标准,探讨我国统一的编码规则。澳大利亚对于医疗性终止妊娠的分类是以胎儿有无存活力(妊娠周期至少20周和/或胎儿重量至少400克)来严格区分的。建议我国也以胎儿有无存活力(妊娠周期至少28周和/或胎儿重量至少1000克)作为划分的标准。胎儿有存活力之前,以类目O04医疗性流产作为主要诊断,终止妊娠的原因作为附加诊断;胎儿具备存活力之后,以终止妊娠的原因作为主要诊断,类目O04医疗性流产作为附加诊断。

This paper starts from the main problems Pregnancy with abortive outcome＂ to state that the actual of coding application in the section of ＂000-008 meaning of ＂004 Medical abortion＂ is ＂medical termination of a pregnancy＂ ; in terms of the confusion about the principle diagnosis for medical termination of pregnancy, this paper takes examples to explain the specific coding steps in Australia and refers to its national coding standards tO explore unified Chinese coding rules as follows： the classification of medical termination of a pregnancy is distinguished by fetal viability in Australia （at least 20 weeks gestation or at least 400g）. It is suggested in China hereby that the classification standard is also defined by fetal viability （at least 28 weeks gestation or at least 1000g）. Before fetal viability, assign a code from category 004 Medical abortion as the principal diagnosis. If the reason for termination is known, assign a code to indicate the reason as an additional diagnosis; after fetal viability, assign a code to indicate the reason for termination as the principal diagnosis. Assign a code from category 004 medical abortions as an additional diagnosis.