多版本融合制定医保疾病诊断和手术操作编码标准

Development of Coding Standards for Medical Insurance Disease Diagnosis and Operation by Multi-Version Fusion

经过前期研究,医保版疾病诊断和手术操作编码标准决定采用多版本融合的路径来应对当前多个疾病诊断和手术操作编码版本并存的状况。本文首先介绍了医保版疾病诊断、手术操作编码标准制定过程所遵循的“科学性、适用性、公允性”原则。接着,说明了此套编码标准的分类框架,即世界卫生组织ICD-10最近更新的类目和亚目、美国ICD-9-CM3最近更新的亚目和细目。然后,详细介绍了条目融合过程、关键步骤和产出。最后,文章分析了制定医保版疾病诊断、手术操作编码标准的策略特点,并对标准的落实执行提出了展望。

After previous research, it is decided that the healthcare security version of the disease diagnosis and operations coding standards adopt a multi-version fusion path to cope with the current coexistence of multiple disease diagnosis and operations code versions. This paper introduces the principles of “scientifi c, applicability, and fairness” followed by the healthcare insurance version of the disease diagnosis and operations coding standards. Next, the classification framework for this set of coding standards is introduced, namely the recently updated categories and sub-heads of the WHO ICD-10, and the recently updated sub-headings and breakdowns of the US ICD-9-CM3. Then, this paper introduces the process, key steps and output of item fusion in detail.Finally, the article analyzes the strategic characteristics of the healthcare security version of the disease diagnosis and operations coding standards, and puts forward the prospect of implementing the standard.