ICD-11糖尿病编码结构及规则  

Analysis of ICD-11 Diabetes Coding Structure and Coding Rules

作　　者：陆田田 陆丹艳[1] 钟婷婷 虞丽霞[2] Lu Tiantian;Lu Danyan;Zhong Tingting;Yu Lixia(Guigang People's Hospital,Guigang 537100,Guangxi Zhuang Autonomous Region,China;不详)

机构地区：[1]贵港市人民医院,广西壮族自治区贵港市537100 [2]广西医科大学第一附属医院,广西壮族自治区南宁市530000

出　　处：《中国病案》2023年第7期47-50,共4页Chinese Medical Record

摘　　要：ICD-11糖尿病编码主要分类于第5章内分泌、营养或代谢疾病,妊娠期糖尿病分类于第18章妊娠、分娩和产褥期,新生儿糖尿病分类于第19章起源于围生期的某些情况,糖尿病并发症的编码一部分分类于第5章内分泌、营养或代谢疾病,另一部分则根据并发症发生的解剖部位和疾病性质分类于对应的其他章节。ICD-11在ICD-10的基础上增加了扩展码来表述解剖部位、严重程度等信息,还增加了预组配、后组配、簇编码的编码组合,更新了ICD的编码结构。糖尿病肾脏病、糖尿病视网膜病两种常见糖尿病并发症的ICD-11编码规则在ICD-10的基础上扩充了临床分期、分型及解剖部位等信息。编码员要加强与临床医师沟通,让临床医师完善住院病案首页的诊断信息,才能更好地满足ICD-11编码的需要,为将来ICD-11在卫生医疗领域的推广做好准备。ICD-11 diabetes codes are mainly classified in Chapter 5 Endocrine,Nutritional,or Metabolic Diseases.Gestational diabetes is classified in Chapter 18 Pregnancy,childbirth,and Puerperium.Diabetes mellitus of the newborn is classified in Chapter 19 Certain Conditions of Perinatal Origin.Part of the coding of diabetic complications is classified in Chapter 5 Endocrine,Nutritional,or Metabolic Diseases,and the other part is classified in other corresponding chapters according to the anatomical site where the complications occur and the nature of the disease.ICD-11 adds extension codes on the basis of ICD-10 to express information such as anatomical location and severity.The coding combination of pre-assembly,post-assembly and cluster coding is also added,and the coding structure of ICD is updated.The ICD-11 coding rules for diabetic nephropathy and diabetic retinopathy,two common diabetic complications,expand the information of clinical stage,type and anatomical site on the basis of ICD-10.Coders should strengthen communication with clinicians and let clinicians improve the diagnostic information on the front pages of inpatient medical records,so as to better meet the needs of ICD-11coding and prepare for the promotion of ICD-11 in the field of health care in the future.

关 键 词：ICD-11 ICD-10 糖尿病 疾病编码 

分 类 号：R197.323[医药卫生—卫生事业管理]