肾内科常见肾替代治疗相关手术操作编码探讨  

Surgical procedure coding for common renal replacement therapies in nephrology

作　　者：苏滔凤 张怡清 杜剑亮 黎欢 SU Taofeng;ZHANG Yiqing;DU Jianliang;LI Huan(The Seventh Affiliated Hospital of Sun Yat-sen University,Shenzhen 518107,China)

机构地区：[1]中山大学附属第七医院,广东深圳518107

出　　处：《现代医院》2024年第8期1206-1210,共5页Modern Hospitals

摘　　要：内科肾替代治疗相关手术操作编码的难点在于编码员对肾替代治疗相关临床知识欠缺及ICD-9-CM-3肾替代治疗相关编码的分类规则理解不透彻。本文通过深入阐述肾替代治疗相关临床知识及整理对应的编码分类规则,梳理出各种不同治疗方式所对应的编码,如创建透析通路,血液透析静脉插管方式编码于38.95、血管造瘘方式编码于39.27,腹膜透析插管编码于皮肤腹膜造口54.93;维持血液透析编码于39.95、腹膜透析编码于54.98;去除透析导管区分手术性和非手术性,手术性去除编码于86.05、非手术性去除编码于97.86或97.89;内瘘狭窄或血栓形成球囊扩张编码于39.50、支架植入治疗狭窄或隔绝假性动脉瘤编码于裸支架39.90、覆膜支架00.55,狭窄或血栓段或假性动脉瘤切除伴重建编码于39.42等,以提高该类编码的正确性。The complexity of coding surgical procedures related to renal replacement therapy in nephrology stems from a deficiency in clinical knowledge regarding renal replacement therapies and an incomplete understanding of the classification rules within the ICD-9-CM-3 coding system.This paper delves into the clinical aspects of renal replacement therapy and organizes the corresponding coding classification rules,clarifying the codes for various treatment modalities.For instance,the establishment of dialysis access is coded as 38.95 for hemodialysis venous intubation,39.27 for vascular fistula,and 54.93 for peritoneal dialysis intubation via a cutaneous peritoneal stoma.Maintenance hemodialysis is coded as 39.95,while peritoneal dialysis is coded as 54.98.The removal of dialysis catheter is differentiated into surgical and non-surgical;surgical removal is coded as 86.05,and non-surgical removal as 97.86 or 97.89.For instances of internal fistula stenosis or thrombosis,balloon dilation is coded as 39.50.Stent implantation for stenosis or isolation of a false aneurysm is coded as 39.90 for bare stent,and 00.55 for covered stents.The resection and reconstruction involving stenosis,thrombus segments,or false aneurysms,are coded as 39.42.This classification aims to improve the accuracy of coding for such procedures.

关 键 词：肾替代治疗 手术操作 ICD-9-CM-3编码 

分 类 号：R197.323.1[医药卫生—卫生事业管理]