ICD-10编码与国际抗癫痫联盟癫痫发作分类匹配分析

Matching Analysis of ICD-10 Coding and the International Anti-Epilepsy Alliance Epileptic Seizure Classification

2017年国际抗癫痫联盟(ILAE)癫痫发作分类发布实行后,癫痫的诊断与ICD-10的分类的匹配工作成为编码的重点工作。本研究通过对比2017版与1981版癫痫发作分类的区别,分析2017版癫痫发作分类在ICD-10中的应用。2017版分类与1981版分类相比并没有本质性的改变,但具有更高的灵活性、更强的准确性等优点。将局灶性起源癫痫、全面性起源癫痫、起源不明癫痫及其他癫痫综合征使用ICD-10编码进行分类。结合实际案例,总结编码方法,利用ICD-10卷三和卷一分析局灶性起源癫痫、全面性起源癫痫、其他癫痫综合征、癫痫持续状态的编码分别为G40.1-G40.2、G40.3-G40.4、G40.0-G40.2以及G40.5、G41。影响癫痫编码准确的因素多为临床医师诊断的模糊和编码员临床知识的匮乏,提出加强交流与学习等改进方法,了解癫痫分类最新要求与进展,力求编码准确,为临床、教学和科研工作提供数据支持。

After the publication and implementation of the International Anti-Epilepsy Alliance(ILAE)epilepsy classification in 2017,the matching of epilepsy diagnosis and ICD-10 classification has become a key coding work.In this study,the application of epileptic seizure classification in ICD-10 was analyzed by comparing the differences between the 2017 version and the 1981 version.Compared with 1981,2017 edition of classification has no essential change,but it has higher flexibility,stronger accuracy and other advantages.Focal epilepsy,generalized epilepsy,epilepsy of unknown origin and other epilepsy syndromes were classified by ICD-10 coding.Combined with actual cases,the coding methods were summarized,and the codes of focal origin epilepsy,generalized origin epilepsy,other epilepsy syndromes and status epilepsy were analyzed by ICD-10 Volume 3 and Volume 1 as G40.1-G40.2,G40.3-G40.4,G40.0--G40.2,G40.5 and G41 respectively.The factors that affect the accuracy of epilepsy coding are the vagueness of diagnosis by clinicians and the lack of clinical knowledge by coders.The improvement methods,such as strengthening communication and learning,are proposed to understand the latest requirements and progress of epilepsy classification and strive for accurate coding,so as to provide data support for clinical,teaching and scientific research work.