结核病ICD-10和ICD-11编码比较与分析

Comparison and Analysis of Tuberculosis’Coding in ICD-10 and ICD-11

归纳结核病在ICD-10和ICD-11中的分布范围,对比分析新旧分类中结核病类目和亚目变化,以及呼吸系统、神经系统、内分泌腺和肌肉骨骼系统结核的编码及差异。ICD-11中潜伏性结核和耐药分枝杆菌所在的章节发生了改变;相较于ICD-10,ICD-11中呼吸系统结核编码变化较大,不仅分类轴心发生改变,而且通过后组配能标识更多解剖部位、耐药信息和病原学检查信息,这与结核病的临床分类更为契合;神经系统结核取消了星剑号编码,使用主干码同时表达病因和临床表现;同时ICD-11中内分泌腺和肌肉骨骼系统结核分类更为集中。ICD-11编码容量更大、疾病表达更细、类目余量更足,但对编码也提出了挑战。通过研究期望能提高编码人员对ICD-11中结核病分类的理解和掌握,为我国顺利实施ICD-11做好专业储备。

We summarized the distribution range of tuberculosis in ICD-10 and ICD-11,and compared and analyzed the changes of tuberculosis’category and subcategory,as well as the coding and differences of tuberculosis in the respiratory system,nervous system,endocrine glands,and musculoskeletal system in the new and old classifications.The results showed that the chapters of latent tuberculosis and drug-resistant mycobacteria had changed in ICD-11.Not only the classification axis was changed,but also more anatomical sites,drug resistance information,and pathogenic examination information can be identified through the post coordination,which is more consistent with the clinical classification.There is no dagger and asterisk code in the nervous system of tuberculosis,and the stem code is used to simultaneously express the cause and clinical manifestation.The classification of tuberculosis in the endocrine gland and musculoskeletal system is more centralized in ICD-11.There is larger coding capacity,the more detailed disease expression and more category margin for ICD-11,however,there is more challenges for coding.One sincere expectation is improving the coders'understanding and ability of the tuberculosis classification in ICD-11 through this research,and making professional reserves for the smooth implementation of ICD-11 in China.