手足外科血管损伤修复手术案例编码讨论

Coding Discussion on Vascular Injury Repair Operation Cases in Hand and Foot Surgery Department

外伤造成的肢体血管损伤情况复杂,涉及的手术方式多样。常用的肢体血管损伤修复术有血管缝合术、血管吻合术、血管移植术、血管转位术、血管结扎术等。血管移植术包括血管皮瓣移植术和血管补片移植术,血管皮瓣移植术编码为86.73,用组织补片移植物不伴切除的血管修补术编码为39.56。病损血管切除长度大于3cm伴置换术编码为38.4。血管吻合术包括血管切除伴吻合术和血管端端吻合术,病损血管切除长度小于2-3cm伴吻合术编码为38.3,血管端端吻合术编码为39.3。编码员需认真阅读手术记录,明确手术术式,正确选择查找路径,才能准确编码。

Limb vascular injury caused by trauma is complex.According to the injury,clinicians choose different surgical methods.It often occurs when the name of the written operation is the same or vague,but the specific operation process is different.The coder should read the operation records carefully,distinguish the surgical procedure,select the leading words,search the index,and finally accurately code.The common repair methods of limb vascular injury are vascular suture,vascular anastomosis,vascular transplantation,vascular transposition,vascular ligation.Vascular transplantation includes vascular patch transplantation and vascular flap transplantation.The code of vascular flap transplantation is 86.73.The code of vascular repair with tissue patch graft without resection is 39.56.The code of diseased vessel resection longer than 3cm with replacement is 38.4.Vascular anastomosis includes vascular resection with anastomosis and direct vascular end-to-end anastomosis.The code of diseased vessel resection less than 2-3cm with anastomosis is 38.3.The code of vascular end-to-end anastomosis is 39.3.