三类常见脑血管病介入治疗编码探讨  

Discussion on Surgical Coding of Interventional Therapy for Three Kinds of Common Cerebrovascular Diseases

作　　者：陈春丽[1] 莫春梅[1] Chen Chunli;Mo Chunmei(Department of Medical Record,West China Hospital of Sichuan University,Chengdu 610041,Sichuan Province,China)

机构地区：[1]四川大学华西医院病案科,四川省成都市610041

出　　处：《中国病案》2024年第2期23-25,共3页Chinese Medical Record

摘　　要：缺血性脑血管病、脑动脉瘤以及脑动静脉畸形是目前脑血管病介入治疗应用较为广泛的三类疾病,针对不同类型的疾病所采用的的具体术式也各有差异。在分析各种操作方式的基础上,根据ICD-9-CM-3的编码规则,确定脑血管病介入治疗的手术编码。缺血性脑血管病球囊扩张成形术编码于00.61(颅外血管)和00.62(颅内血管),支架置入术编码于00.63(颈动脉)、00.64(颅外血管)和00.65(颅内血管),血管内取栓编码于39.74。脑动脉瘤血管内栓塞根据不同栓塞材料编码于39.72(支架、液体栓塞剂、血管内移植物等)、39.75(裸弹簧圈)和39.76(生物活性弹簧圈)。脑动静脉畸形介入治疗主要编码于39.72。此外,还需要注意不能遗漏需要使用的“另编码”。编码员应充分了解脑血管的解剖结构及介入治疗的术式和材料,并与编码内涵相结合,确保编码的准确性。At present,ischemic cerebrovascular disease,cerebral aneurysm and cerebral arteriovenous malformation are three kinds of diseases widely used in interventional therapy of cerebrovascular disease,and the specific operation methods used for different types of diseases are also different.Based on the analysis of various operation methods,the surgical code of interventional therapy for cerebrovascular diseases was determined according to the coding rules of ICD-9-CM-3.The codes for balloon dilatation for ischemic cerebrovascular disease are 00.61(extracranial vessels)and 00.62(intracranial vessels),stenting is 00.63(carotid arteries),00.64(extracranial vessels)and 00.65(intracranial vessels),and endovascular thrombectomy is 39.74.Endovascular embolization of cerebral aneurysms is coded as 39.72(stent,liquid embolization agent,endovascular graft,etc.),39.75(bare spring ring)and 39.76(bioactive spring ring)according to different embolization materials.Interventional treatment of cerebral arteriovenous malformation was mainly coded in 39.72.In addition,it is also necessary to take care not to leave out the"alternative code"that needs to be used.Coders should fully understand the anatomical structure of cerebral vessels and the operation methods and materials of interventional therapy,and combine with the connotation of coding to ensure the accuracy of coding.

关 键 词：脑血管病 介入治疗 ICD-9-CM-3 编码 

分 类 号：R197.323[医药卫生—卫生事业管理]