造血干细胞移植的编码分析

Coding Analysis of Hematopoietic Stem Cell Transplantation

造血干细胞移植主要有造血干细胞采集、预处理、回输3个环节,根据ICD-10和ICD-9-CM-3编码原则对各环节编码进行归纳总结,造血干细胞采集根据供者类型和采集部位不同,诊断编码有Z52.0供干细胞者、Z52.3供骨髓者、Z51.4造血干细胞动员,操作编码有99.79干细胞采集、41.91供者骨髓采集术;预处理根据处理方式不同,操作编码可分为单纯化学治疗99.25静脉注射化疗药物、放射+化学治疗92.2放射治疗和99.25静脉注射化疗药物;干细胞回输根据免疫遗传学分类不同,操作编码可分为自体造血干细胞移植41.09自体骨髓移植伴净化、41.01自体骨髓移植不伴净化、41.07自体造血干细胞移植伴净化、41.04自体造血干细胞移植不伴净化,同基因造血干细胞移植、异基因造血干细胞移植41.03异体骨髓移植、41.05异体造血干细胞移植、41.06脐带血干细胞移植。造血干细胞移植的相关诊断和手术操作编码,因供者类型、采集部位、处理方式、免疫遗传学分类的不同而有所区别,编码员只有熟练掌握各个环节诊断和治疗方式的不同,准确掌握编码规则,才能做到准确编码。

Hematopoietic stem cell transplantation mainly includes three links:hematopoietic stem cell collection,pretreatment,and reinfusion.According to the coding principles of ICD-10 and ICD-9-CM-3,the coding of each link is summarized.According to different types of donors and different collection sites,The diagnostic codes for hematopoietic stem cell collection include Z52.0 for stem cell donors,Z52.3 for bone marrow donors,and Z51.4 for hematopoietic stem cell mobilization.Operation codes include 99.79 stem cell collection and 41.91 donor bone marrow collection;According to different pretreatment methods,the operation codes can be divided into simple chemotherapy 99.25 intravenous chemotherapy drugs,radiation + chemotherapy 92.2 radiotherapy and 99.25 intravenous chemotherapy drugs;stem cell reinfusion can be classified into autologous hematopoietic stem cell transplantation according to different classifications of immunogenetics.41.09 autologous bone marrow transplantation with external purification,41.01 autologous bone marrow transplantation without external purification,41.07autologous hematopoietic stem cell transplantation with external purification,41.04 autologous hematopoietic stem cell transplantation without external purification,Syngeneic hematopoietic stem cell transplantation,allogeneic hematopoietic stem cell transplantation 41.03 allogeneic bone marrow transplantation,41.05 allogeneic hematopoietic stem cell transplantation,41.06 cord blood stem cell transplantation.Diagnosis and surgical operation codes related to hematopoietic stem cell transplantation are different due to the type of donor,collection site,treatment method,and immunogenetics classification.Coders can only achieve accurate coding only if they are proficient in the different diagnosis and treatment methods of each link,and accurately master the coding rules.