植入式神经刺激的ICD-9-CM-3编码探讨

Application of Implantable Nerve Stimulator and Discussion on the Coding of ICD-9-CM-3

植入式神经刺激分为脑深部电刺激、脊髓电刺激和周围神经电刺激3种类型,由电极和脉冲发生器两部分构成。根据国际疾病分类手术与操作分类的编码规则,需区分神经刺激植入的部位,明确具体手术和脉冲发生器类型。手术操作编码包括:⑴电极:①脑深部电刺激的植入/置换02.93、去除01.22;②脊髓电刺激的植入/置换03.93、去除03.94;③周围神经电刺激的植入/置换04.92、去除04.93;⑵脉冲发生器:①皮下组织的植入/置换86.94-86.98、去除86.05;②颅内的植入/置换01.20、去除01.29。通过剖析具体案例,总结编码要点,旨在理清手术操作编码,提高植入式神经刺激手术操作编码的正确率。

Implantable nerve stimulator includes three types:Deep Brain Stimulation(DBS),Spinal Cord Stimulation(SCS)and Peripheral Nerve Stimulation(PNS),which are composed of electrode and pulse generator.According to the coding rules of the International Classification of Diseases,it is necessary to distinguish the location of nerve stimulator implantation and clarify the specific operation and pulse generator type.The operation code includes:(1)electrode:①DBS:implantation/replacement and removal codes are 02.93 and 01.22;②SCS:implantation/replacement and removal codes are 03.93 and 03.94;③PNS:implantation/replacement and removal codes are 04.92 and 04.93;(2)Pulse generator:①subcutaneous tissue:implantation/replacement and removal codes are 86.94-86.98 and 86.05;②Intracranial pulse generator:implantation/replacement and removal codes are 01.20 and 01.29.Through analyzing specific cases,this paper summarizes the coding mistakes,aiming at clarifying the surgical operation code and improving the accuracy of the surgical operation code of the implanted nerve stimulator.