免疫检查点抑制剂相关性肺炎ICD-10编码探讨

Study on ICD-10 Coding of Immune checkpoint Inhibitor Associated Pneumonia

免疫检查点抑制剂相关性肺炎是肿瘤免疫治疗中一种常见的不良反应。该病缺乏特异的临床表现,具有肿瘤免疫治疗药物使用史、毛玻璃或实变影的影像学表现、抗菌药物使用无效、激素治疗有效等特点。一般起病较急,经激素治疗和(或)停用肿瘤免疫治疗药物可好转。ICD-10中未直接给出本病的编码。通过学习相关文献,整理了免疫检查点抑制剂相关性肺炎的发病机制、临床表现、影像学特征等,得出免疫检查点抑制剂相关性肺炎的诊断编码为J70.2,并根据所用药物得出外因编码Y43.4。编码员在掌握疾病分类相关知识的同时也要不断加强临床知识的学习,通过查阅文献、与医师交流等方式提升编码能力。

Immune checkpoint inhibitor associated pneumonia is a common adverse reaction in tumor immune therapy.The disease lacks specific clinical manifestations,and has the characteristics of tumor immune therapy drug use history,ground glass or consolidation image performance,ineffective use of antibiotics,effective hormone therapy and so on.Generally,the onset of the disease is acute,and it can be improved by hormone therapy and(or)discontinuation of tumor immune therapy drugs.ICD-10 did not give the coding of the disease directly.In this paper,through studying the relevant literature,we sorted out the pathogenesis,clinical manifestations,imaging characteristics of immune checkpoint inhibitor associated pneumonia,and obtained the diagnostic code of immune checkpoint inhibitor associated pneumonia as j70.2,and the external cause code y43.4 according to the drugs used.While mastering the relevant knowledge of disease classification,coders should constantly strengthen the learning of clinical knowledge,and improve their coding ability by consulting literature and communicating with doctors.