支气管镜操作编码探讨  

Exploration of Bronchoscopy Operation Coding

作　　者：纪德胜 彭城 黄颖 任妮丽 Ji Desheng;Peng Cheng;Huang Ying;Ren Nili(Department of Medical Records and Statistics,Wuhan Pulmonary Hospital,Wuhan 430030,Hubei Province,China;不详)

机构地区：[1]武汉市肺科医院病案统计科,湖北省武汉市430030

出　　处：《中国病案》2024年第12期23-25,共3页Chinese Medical Record

基　　金：武汉市卫生健康委科研资助项目(WX23B47)。

摘　　要：在ICD-9-CM-3中,单纯支气管镜检查的编码要点在于鉴别支气管镜的类型,通常分为纤维支气管镜、经气管造口支气管镜检查和其他支气管镜检查;支气管镜活检编码除需要注意支气管镜类型外,还需明确活检部位,多为肺部或支气管;支气管镜下支架置入编码与支气管球囊扩张术在ICD-9-CM-3中均有2条查询路径,在类目表核实时,一般要注意类目的术式是否是内镜下的操作,同时需要核实类目表的编码内涵与操作的内涵是否一致;支气管镜下瓣膜置入编码与置入瓣膜的数量相关,一般分为单叶与多叶;支气管镜下支气管内物质取出编码要注意区分取出的物质类型,其中异物取出编码于98.15,治疗性装置取出编码于33.78;支气管镜下病损清除术多分为切除术和破坏术,编码时需关注清除术的类型和病损部位。在编码实践中,支气管镜下支气管球囊扩张术在《手术操作分类代码国家临床版3.0》中应用的编码与ICD-9-CM-3查询编码不同,前者强调扩张术是内镜下的操作;支气管镜下病损清除术在《手术操作分类代码国家临床版3.0》中的破坏术和切除术编码类目虽然相同,但在扩展码上有差异,在编码实践中,应根据清除术的类型选择合适的扩展码,保证支气管镜操作编码的准确性和合理性。In ICD-9-CM-3, the coding point of simple bronchoscopy is to distinguish the type of bronchoscopy, which is usually divided into fiberoptic bronchoscopy, tracheostomy bronchoscopy, and other bronchoscopy examinations;In addition to paying attention to the type of bronchoscopy, the coding of bronchoscopy biopsy also needs to clarify the biopsy site, which is mostly in the lungs or bronchi;There are two query paths in ICD-9-CM-3 for the encoding of bronchoscopic stent placement and bronchoballoon dilation surgery. In the category list, it is generally important to pay attention to whether the surgical method in the category is endoscopic,and to verify whether the encoding content in the category list is consistent with the operation content;The coding of valve placement under bronchoscopy is related to the number of implanted valves, generally divided into single lobe and multi lobe;When removing substances from the bronchus under bronchoscopy, attention should be paid to distinguishing the type of substance being removed. The foreign body removal code is 98.15, and the therapeutic device removal code is 33.78;Bronchoscopic lesion removal surgery is often divided into resection surgery and destruction surgery, and when coding, attention should be paid to the type of removal surgery and the location of the lesion. In coding practice, the coding used for bronchoscopic balloon dilation surgery in the National Clinical Edition 3.0 of the Classification Code for Surgical Operations is different from the ICD-9-CM-3 query coding. The former emphasizes that dilation surgery is an endoscopic operation;Although the coding categories for destructive surgery and resection surgery in the National Clinical Version 3.0 of the Classification Code for Surgical Operations are the same, there are differences in the extension codes for bronchoscopic lesion removal. In coding practice,appropriate extension codes should be selected based on the type of removal surgery to ensure the accuracy and rationality of bronchoscopic operation cod

关 键 词：支气管镜 诊断性操作 治疗性操作 手术操作编码 

分 类 号：R197.323[医药卫生—卫生事业管理]