Zhou Jie | DRG app 1 foot: ICD code

Hemorrhoids

Medical columnist: Zhu Jie
Du Yun, senior product director.
Begonia has no fragrance.
Bees have many thorns.
The red building has no end.
These are the three regrets of Zhang Ailing's life.
As Zhang Ailing said, "Begonia has no fragrance, towel gourd has thorns." the seemingly perfect plan will cover up the pit of love and hate, and the pit of DRG is on ICD.
Speaking of ICD, at the beginning of the new century, mainland China introduced the medical management system. We have no historical burden of overtaking in corners. In the United States, ICD-9 directly applies ICD-10 as the diagnostic classification coding standard of the home page of discharged patients' medical records, becoming a famous "ICD".
Everything is going well. From 2009, CMS announced that it would postpone the upgrade period of diagnostic codes sent by hospitals to medical insurance data for two years. From 2011 to 2013. Looking at the fire across the coast, I was surprised to find that the code upgrade would cause such a big storm to the hit industry across the coast. After that, the target time was advanced. Unexpectedly, the dust was settled in October 2015, and the system upgrade of icd-10-cm will be carried out nationwide. This is the 19th year since the EDI specification of HIPAA act in 1996 proposed the unified use of ICD10 code.
On the contrary, ICD coding has never aroused such high interest in China. For many years, ICD coding is only the task of the medical record department. If the health commission does not use this data item for statistics, will you see code quality? Maybe no one will be too involved.
More serious hospitals have built the corresponding relationship between clinical diagnosis and ICD codes commonly used by departments in the information system, but the effect depends on different opinions. At present, the method of handling ICD in most his / EMR systems is to make charts from general clinical diagnosis names to ICD diagnosis codes. When doctors input general clinical diagnosis, the system will automatically carry ICD code.
To be honest, if such a "response table" is formulated, the United States will not have to struggle for 19 years. How could such a good thing happen? The location of ICD is a classification code defined for statistics, but the purpose of clinical diagnostic terminology is to describe the disease name, location, onset stage and severity of a specific patient. The two words have different structures and cannot correspond to each other one by one. Moreover, clinical diagnosis vocabulary itself is not a stable form, but develops continuously with the development of clinical medicine.
Therefore, the emergence of "ICD dilemma" with Chinese characteristics has the side that clinicians do not understand, do not understand and despise ICD passwords. In another case, in the Katakana of medical records, the person in charge of ward coding collected various data, all of which were supplemented by the brain and completed ICD coding. The correctness of the final code cannot be further confirmed.