恶性间皮瘤ICD编码案例分析

Case Analysis of ICD Coding for Malignant Mesothelioma

恶性间皮瘤侵袭性高,隐匿性强,且发病原因复杂。ICD-10对于恶性间皮瘤部位分类特殊,病理分型多样,对临床知识要求较为专业,编码员在实际工作中极易出错。ICD-10将恶性间皮瘤部位编码与形态学编码进行了先组配,不应按照肿瘤编码查找原则进行查找。对ICD-10恶性间皮瘤索引共列出了13个部位编码进行总结,发现ICD-10将最常见的胸膜及胸膜壁层分类于C45.0;腹膜(壁层)(骨盆的)、肠系膜、结肠系膜、网膜、分类于C45.1;心包单独分类于C45.2;将不常见的肺、腹膜后、肝、纵膈及除去上述C45.0-C45.2的特指部位均分类于C45.7;未特指部位的恶性间皮瘤分类于C45.9。本文通过对恶性间皮瘤案例进行回顾性分析,剖析亚目之间的关系,列举恶性间皮瘤形态学编码,指导编码员正确进行编码。

Malignant mesothelioma is highly aggressive,insidious,and has complex causes.ICD-10 has a special classification for the location of malignant mesothelioma,and has a variety of pathological types,which requires more professional clinical knowledge.The coders are prone to make mistake in actual work.ICD-10 combines the site code of malignant mesothelioma with the morphological code,and it should not be searched according to the principle of tumor code search.The ICD-10 malignant mesothelioma index lists a total of 13 site codes.It is found that ICD-10 classifies the most common pleura and pleural parietal layers in C45.0;peritoneum(parietal)(pelvic),mesenteric,Colonic mesangium,omentum are classified in C45.1;pericardium alone is classified in C45.2;uncommon lung,retroperitoneum,liver,mediastinum and specific parts except for the above C45.0-C45.2 are classified in C45.7;unspecified malignant mesothelioma is classified in C45.9.This article conducts a retrospective analysis of cases of malignant mesothelioma,analyzing the relationship between subcategories,enumerating the morphological codes of malignant mesothelioma,and guiding coders to code correctly.