人工动静脉内瘘并发症及相关手术编码的解析  

Complications of Surgically Created Arteriovenous Fistula and Analysis of Operation Codes

作　　者：杨远城 邱雨涛 Yang Yuancheng;Qiu Yutao(Department of Medical Records,Red Cross Hospital,School of Medicine,Jinan University,Guangzhou 510220,Guangdong Province,China;不详)

机构地区：[1]广州市红十字会医院,暨南大学附属广州红十字会医院病案室,广东省广州市510220 [2]广东省医学科学院广东省人民医院病案科,广东省广州市510080

出　　处：《中国病案》2021年第8期46-48,共3页Chinese Medical Record

摘　　要：基于人工动静脉内瘘常见的两种并发症,即狭窄和血栓形成,通过阅读相关文献,根据ICD-10和ICD-9-CM-3的编码原则,对其诊断编码进行解析。在另一方面,结合实际案例,对两种并发症的相关手术编码进行探讨。自体动静脉内瘘狭窄与血栓形成的编码均为I97.8,而人工血管吻合口和管腔内的狭窄与血栓形成的编码为T82.8,Y83.1。当利用手术治疗人工动静脉内瘘的狭窄与血栓形成时,根据患者情况不同选择正确的术式,从而确定对应的编码,单纯的血管内溶栓编码为99.10,吸栓和碎栓编码为39.49,球囊扩张血管成形术为39.50,狭窄处支架置入术编码为39.90。目的是提醒编码员需认真阅读病历,结合患者实际情况,熟练掌握编码原则,正确施用编码技术,丰富各学科临床专业知识,多与临床医师沟通,以提高相关编码正确率。以免造成编码的错编及漏编。Based on the two common complications of artificial arteriovenous fistula,namely stenosis and thrombosis,through reading the relevant literature,according to the coding principle of ICD-10 and ICD-9-CM-3,the diagnostic code was analyzed.On the other hand,combined with the actual cases,the related operation codes of the two complications were discussed.Artificial arteriovenous fistula stenosis and thrombosis share the same code I97.8.Codes for stenosis and thrombosis for surgically created vascular anastomosis are T82.8,Y83.1.When using surgery to treat the stenosis and thrombosis of artificial arteriovenous fistula,the correct operation method should be selected according to the different conditions of patients,so as to determine the corresponding coding,the intravascular thrombolysis code was 99.10,the aspiration and fragmentation share the same code 39.49,the balloon dilatation code was 39.50,and the stent placement code was 39.90.The coder should read the medical records carefully,master the coding principles and correctly use the coding technology according to the actual situation of patients.

关 键 词：人工动静脉内瘘 ICD-10 ICD-9-CM-3 手术编码 

分 类 号：R692.5[医药卫生—泌尿科学] R197.323[医药卫生—外科学]