先天性心脏病介入治疗手术编码探讨

Discussion on Surgical Coding for Interventional Treatment of Congenital Heart Disease

先天性心脏病的介入治疗主要涉及先天性血管畸形、先天性心脏瓣膜病和房室间隔缺损等疾病。在分析各种手术方式的基础上,确定先天性心脏病介入治疗的手术编码。血管畸形主要包括大动脉畸形(Q25)和冠状动脉瘘(Q24.5),血管畸形球囊扩张编码于39.50(周围血管)、00.66(冠状动脉),支架植入主要编码于36.06(冠状动脉非药物洗脱支架)和36.07(冠状动脉药物洗脱支架)、39.90(周围血管),血管内栓塞主要编码于39.79(周围血管)和36.99(冠状动脉)。先天性心脏瓣膜病(Q22-Q23)介入治疗中,瓣膜球囊扩张编码于35.96,主动脉瓣膜置换编码于35.05(经血管)和35.06(经心尖),二尖瓣置换编码于35.97,肺动脉瓣置换编码于35.07。房/室间隔缺损(Q21.2/Q21.1)介入治疗主要编码于35.52(房间隔缺损封堵术)和35.55(室间隔缺损封堵术),对于手术编码体系中暂时无法分类的经胸小切口房间隔缺损封堵术和经胸小切口室间隔缺损封堵术建议归类于35.51和35.53。

Interventional treatment of congenital heart disease mainly involves congenital vascular malformations,congenital heart valve disease and atrioventricular septal defect.Vascular malformations mainly include aortic malformations(Q25)and coronary fistulas(Q24.5).The vascular malformations balloon dilatation code is 39.50(peripheral blood vessels)and 00.66(coronary artery),and stent implantation is mainly coded at 36.06(coronary artery non-drug).Eluting stent and 36.07(coronary artery drug-eluting stent),39.90(peripheral vessel),intravascular embolization is mainly coded at 39.79(peripheral vessel)and 36.99(coronary artery).In the interventional treatment of congenital valvular heart disease(Q22-Q23),balloon dilatation is coded at 35.96,aortic valve replacement is coded at35.05(transvascular)and 35.06(trans-apex),mitral valve replacement is coded at 35.97,pulmonary valve The replacement code is 35.07.Atrial/ventricular septal defect(Q21.2/Q21.1)interventional therapy is mainly coded in35.52(atrial septal defect closure)and 35.55(ventricular septal defect closure),for transthoracic surgery that cannot be classified temporarily in the surgical coding system Small incision atrial septal defect closure and transthoracic small incision ventricular septal defect closure are recommended to be classified in 35.51 and 35.53.