长春市医疗保险定点医院诊疗项目编码标准化研究  

Research on Coding Standardization of Diagnosis and Treatment Items in Medical Insurance Designated Hospitals in Changchun City

作　　者：徐长妍[1] 刘春萍[1] 马鸿雁[1] 马洪喜[1] 

机构地区：[1]吉林大学白求恩第一医院,长春市130021

出　　处：《中国病案》2011年第10期34-35,共2页Chinese Medical Record

基　　金：吉林省卫生厅科研课题资助项目(编号:2010R003)

摘　　要：目的建立长春市医疗保险定点医院诊疗项目编码目录。方法运用网络信息技术及ICD-9-CM-3,采用理论与实践相结合,专家指导与病例分析相结合,资料查询与调查研究相结合的方法,对长春市医疗保险定点医院上报的2008年及2009年诊疗项目名称进行检索、纠错及对照。结果目前长春市医疗保险定点医院上传至长春市医保局的诊疗项目名称不统一、不规范,应加强对定点医院编码人员和临床医师的ICD知识和技能培训,并保证地区范围内ICD编码库的统一性。结论长春市医疗保险定点医院实行统一的诊疗项目编码,是长春市医保局科学管理医疗保险基金合理支出的前提和保障。Objective To establish the coding catalogue of diagnosis and treatment items in the medical insurance designated hospitals in Changchun city.Methods The diagnosis and treatment items from 2008 to 2009 were retrieved,rectified and compared by using the methods of internet information technique and ICD-9-CM-3,integrating the theory with the practice,combining the experts＇ guidance with the case analysis and integrating the data query with the survey.Results The current data of diagnosis and treatment items in Changchun medical insurance bureau which is from the medical insurance designated hospitals is disunity and irregular.The cultivation of ICD knowledge and skill of the coding in the medical insurance designated hospitals should be improved to ensure the uniformity of ICD coding database in the same district.Conclusion Using the unified coding standardization of in medical insurance designated hospitals in Changchun city is the precondition and safeguard for the medical insurance bureau to manage the reasonable expenditure scientifically of the medical insurance funds.

关 键 词：诊疗项目 编码标准化 医疗保险 ICD 

分 类 号：R197.3[医药卫生—卫生事业管理]