肠造口治疗相关手术编码探讨

Discussion on the Surgical Coding of Enterostomy Treatment

肠造口治疗作为粪便转流是非常重要的消化道手术之一,但是因其临床分类的复杂性给编码工作带来一定的困难。临床上依据造口的部位、形状、功能、目的、造口的保留时间对其进行分类,而肠造口手术治疗编码主要依据肠造口的3个临床特征进行分类,分别是造口形状(是否襻式)、造口部位(回肠、结肠)和造口保留时间(暂时性、永久性),主要编码于46.0、46.1和46.2。节制性肠造口属于一种特殊的肠造口,根据不同的部位回肠编码于46.22,结肠编码于46.13。肠造口术后结局主要是还纳和针对造口并发症的处理,常见并发症有造口的缺血坏死、造口出血、造口脱垂、造口旁疝、造口狭窄等,临床的处置治疗方式也各自不同,对应不同的手术操作编码。编码员只有不断的学习临床知识才能更好更准确的进行编码。

Enterostomy treatment is one of the most important digestive tract surgery as fecal diversion, but the complexity of its clinical classification has caused certain difficulties for coding. Clinically, the stoma is classified according to its location, shape, function and purpose, and the retention time of the stoma. The surgical treatment code for enterostomy is mainly classified based on the three clinical characteristics of the stoma, namely the shape of the stoma(Whether loop type), stoma site(ileum, colon) and stoma retention time(temporary, permanent), are mainly coded in 46.0, 46.1, and 46.2. Controlled enterostomy is a special type of enterostomy, coded at 46.22(ileum) and 46.13(colon) according to different parts. The postoperative outcome of an intestinal stoma is mainly reconciliation and the treatment of stoma complications. This article also summarizes the stoma reconduction and the treatment methods of different stoma complications and their related surgical codes. Only by constantly learning clinical knowledge can coders perform better and more accurate coding.