减重代谢术编码分析

Coding Analysis of Weight Loss Metabolism

临床常用的3种减重代谢术分别为腹腔镜胃袖状切除术、腹腔镜胃袖状切除联合空肠空肠旁路术和腹腔镜胃旁路术。国际疾病分类第九版临床修订本手术与操作(ICD-9-CM-3)2011版腹腔镜胃袖状切除的主要手术细目码为43.82;腹腔镜胃袖状切除联合空肠空肠旁路的主要手术细目码为43.82,附加细目码为45.91;腹腔镜胃旁路术的主要手术细目码为44.38。减重代谢术编码易错点:混淆手术入路,常见的3种手术入路为腹腔镜、开放性和经皮(内镜的);腹腔镜胃袖状切除联合空肠空肠旁路术误编为胆胰分流并十二指肠转位术(43.82+45.91+45.51);腹腔镜胃旁路术主要手术错编为胃部分切除(43.7);遗漏附加编码的使用;多编码应该省略的编码。

In order to improve the correctness and integrity of the coding of weight loss metabolic surgery,the medical record management system of a tertiary A comprehensive hospital is now used to extract all weight loss metabolic surgery carried out from January 1st,2018 to December 31st,2021.Through classification and summary,it is concluded that the three types of weight loss metabolic surgery commonly used in the hospital are laparoscopic gastric sleeve resection,laparoscopic gastric sleeve resection combined with jejunum jejunum bypass,and laparoscopic gastric bypass.In combination with the International Classification of Diseases(ICD-9-CM-3),the clinical revision of the ninth edition,surgery and procedures(ICD-9-CM-3),2011 edition,the main operation detail code of laparoscopic gastric sleeve resection was 43.82;The main operation detail code of laparoscopic sleeve gastrectomy combined with jejunum jejunum bypass is 43.82,and the additional detail code is 45.91;The main operative code of laparoscopic gastric bypass was 44.38.Error prone points in coding of weight loss and metabolism surgery:confusion of surgical approaches.The three common surgical approaches are laparoscopic,open and percutaneous(endoscopic);Laparoscopic sleeve gastrectomy combined with jejunojejunal bypass was wrongly classified as biliary pancreatic shunt and duodenal transposition(43.82+45.91+45.51);Laparoscopic gastric bypass was mistaken for partial gastrectomy(43.7);Omission of the use of additional codes;Multiple codes should be omitted.