DRG支付下白血病ICD-10编码分析  

Analysis of ICD-10 coding for leukemia under DRG payment

作　　者：潘艳芳 李贞 赵华 PAN Yanfang;LI Zhen;ZHAO Hua(School of Information and Management,Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学信息与管理学院,广西南宁530021 [2]柳州市人民医院,广西柳州545006

出　　处：《现代医院》2025年第4期553-555,559,共4页Modern Hospitals

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20200161)。

摘　　要：白血病是一种常见的血液系统恶性肿瘤,其ICD编码的精确性在病案管理与DRG分组中占据核心地位。目前,临床实践中同时采用法美英(FAB)分型与世界卫生组织(WHO)分型对白血病进行分类。随着MICM(形态学、免疫学、遗传学和分子生物学)技术的引入,白血病的分类体系更加精细化,这也增加了病案编码的复杂性。因此,病案编码员需要紧跟医学发展的前沿,深入掌握白血病的最新分型标准,系统总结髓样白血病、淋巴样白血病及未分型白血病的编码要点与思路,并明确白血病C编码作为主要诊断的情况。在DRG支付改革的背景下,临床医生应准确填写病案首页中的疾病诊断和手术操作信息,而编码员在进行病案首页编码时,需综合考虑主要诊断选择的三原则以及当地的DRG分组规则,以确保主要诊断的准确选择,从而提升DRG入组正确率,为医疗资源的合理分配提供可靠依据。Leukemia is a common malignant tumor of the blood system,and the accuracy of ICD coding plays a key role in medical record management and DRG grouping.Currently,in clinical practice,both French-American-British(FAB)classification and World Health Organization(WHO)classification are used for leukemia classification.With the introduction of MICM(morphology,immunology,genetics and molecular biology)technology,the leukemia classification system has become more refined,which also increases the complexity of medical record coding.Therefore,medical record coders need to keep up with the forefront of medical development,thoroughly understand the latest classification standards of leukemia,systematically summarize the coding points and ideas for myeloid leukemia,lymphoid leukemia and unclassified leukemia,and clarify the situation where leukemia is coded as the main diagnosis.In the context of DRG payment reform,clinical doctors should accurately fill in the disease diagnosis and surgical operation information on the medical record cover,and when coding the medical record cover,the coder needs to comprehensively consider the three principles of selecting the main diagnosis and the local DRG grouping rules to ensure the accurate selection of the main diagnosis,thus improving the accuracy of DRG admission and providing a reliable basis for the rational allocation of medical resources.

关 键 词：白血病 DRG 髓细胞性白血病 淋巴细胞性白血病 

分 类 号：R197[医药卫生—卫生事业管理]