国家临床3.0版ICD-9-CM-3乳突根治术及鼓室成形术编码分析  

Coding Analysis of Radical Mastoidectomy and Tympanoplasty under National Clinical Version 3.0 ICD-9-CM-3

作　　者：关宏[1] 郭淑芹[1] 贾同乐 Guan Hong;Guo Shuqin;Jia Tongle(The First Central Hospital of Baoding in Hebei Province,Baoding 071000,Hehei Province,China;不详)

机构地区：[1]河北省保定市第一中心医院,河北省保定市071000

出　　处：《中国病案》2022年第5期9-11,共3页Chinese Medical Record

摘　　要：乳突根治术及鼓室成形术操作、解剖关系复杂,各类文献中乳突手术的名称不统一,使得乳突根治术和鼓室成型术编码的鉴别分型较难掌握。通过研读国内外相关文献,结合耳鼻喉头颈手术学、局部解剖学,分析手术记录,根据国家临床3.0版ICD-9-CM-3分析乳突根治术及鼓室成形术编码。广义的乳突根治术可以分为开放式乳突根治术、完壁式乳突改良根治术2大类。开放式乳突根治术又根据手术范围大小细分为根治性乳突切除术和开放式乳突改良根治术2种。在基础版ICD-9-CM-3中将根治性乳突切除术分类于20.42,将乳突改良根治术分类于20.49;由于基础版ICD-9-CM-3中未提及完壁式乳突改良根治术,国家临床版3.0版将乳突改良根治术20.49的细目扩展为20.4900×008和20.4900×009,分别对应开放式乳突改良根治术和完壁式乳突改良根治术。鼓室成形术可以分为5型19.4、19.52-19.55。The operation and anatomy of radical mastoidectomy and tympanoplasty are complicated,and the name of mastoid surgery in various literatures are not uniform.So the coding of radical mastoidectomy and tympanoplasty is not easy to grasp.In this article the coding of radical mastoidectomy and tympanoplasty are analyzed according to the classification principle of the latest national clinical version 3.0 ICD-9-CM-3 system,by reading the literature related to mastoidectomy and tympanoplasty at home and abroad,analyzing the surgical records in combination with the knowledge of medical surgery and the regional anatomy.Radical Mastoidectomy can be divided into two categories:Canal wall down radical mastoidectomy and intact canal wall radical mastoidectomy.Canal wall down radical mastoidectomy is further divided into canal wall down classical radical mastoidectomy and canal wall down modified radical mastoidectomy according to the scope of operation.In the basic ICD-9-CM-3,the classical canal wall down radical mastoidectomy was classified under 20.42,and the modified under 20.49.Because intact canal wall radical mastoidectomy did not be mentioned in the basic ICD-9-CM-3,the 20.49category is expanded to 20.4900×008 and 20.4900×009,which correspond to canal wall down modified radical mastoidectomy and intact canal wall modified radical mastoidectomy respectively in the NCV3.0.Tympanoplasty can be divided into five types 19.4,19.52-19.55.

关 键 词：乳突根治术 鼓室成形术 国家临床3.0版ICD-9-CM-3 编码 

分 类 号：R764.9[医药卫生—耳鼻咽喉科] R197.323[医药卫生—临床医学]