抗生素骨水泥手术操作编码应用  

Application of Antibiotic Bone Cement Operation Coding

作　　者：林梦霞 陈俊伟 Lin Mengxia;Chen Junwei(Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning 530012,Guangxi Zhuang Autonomous Region,China;不详)

机构地区：[1]广西中医药大学附属瑞康医院医务部病案室,广西壮族自治区南宁市530012 [2]遵义医科大学附属医院医务处病案管理科,贵州省遵义市563003

出　　处：《中国病案》2025年第3期26-28,共3页Chinese Medical Record

摘　　要：抗生素骨水泥(ALBC)具有延展性高、抗菌能力强和促进诱导生物膜生成等各种特性,主要用于各类骨缺损的填充、关节腔隙占位和慢性创面覆盖。ALBC临床应用广泛。通过ICD-9-CM-3索引查找得到骨缺损骨水泥植入编码于84.55;填充物(水泥)(关节)置入84.56,需要注意索引圆括号和注释信息提示84.56指关节部位的填充或占位;骨水泥覆盖于慢性软组织创面的编码易混淆,易错编码至水泥间隔物植入84.56或86.02皮肤缺损注射或文身,应结合ALBC可作为生物敷料的特性,转换敷料为主导词查找得到骨水泥敷料编码93.57。与骨水泥混合的药物不同,编码亦有区别,非噁唑烷酮类抗生素编码99.21,噁唑烷酮类抗生素编码00.14,非抗生素类抗感染药物则编码99.22,且均作为附加编码体现。抗生素骨水泥植入编码需要明确植入部位和植入方式,掌握相关临床知识,编码员应积极与临床沟通,帮助临床医师提高病历书写质量,认真查阅核对工具书,从而提高编码正确率。Antibiotic-loaded bone cement(ALBC)has various properties such as high ductility,strong antibacterial ability,promoting and inducing biofilm formation,etc.It is mainly used for filling various bone defects,occupying joint spaces and covering chronic wounds.ALBC has a wide range of clinical applications,but it is difficult for coders to accurately code ALBC implantation.According to the ICD-9-CM-3 index,bone cement implantation for bone defect is coded as 84.55.The filling(cement)(joint)is placed in 84.56;It is important to note that the index parentheses and the annotation indicate that 84.56 refers to the filler or space holder at the joint location.The code of bone cement covering chronic soft tissue wounds is easy to be confused.When consulting reference books,coders did not carefully check and understand relevant clinical knowledge,and easily coded cement spacer implantation 84.56 or skin defect injection or tattoo 86.02.In view of the characteristics of ALBC as a biological dressing,the coder should change the word"dressing"to the leading word and search for the bone cement dressing code 93.57.Unlike drugs mixed with bone cement,the coding is also different.Non-oxazolidinone antibiotics are coded as 99.21,oxazolidinone antibiotics are coded as 00.14,non-antibiotic anti-infective drugs are coded as 99.22,and all are represented as additional codes.The coding of antibiotic bone cement implantation requires clear implantation site and method,and the mastery of relevant clinical knowledge.Coders should actively communicate with clinicians,help clinical physicians improve the quality of medical record writing,and carefully consult and check reference books to improve the accuracy of coding.

关 键 词：抗生素骨水泥 间隔物 ICD-9-CM-3编码 

分 类 号：R197.3[医药卫生—卫生事业管理]