Research letters. Guidelines and statements. Narrative reviews. Ethics and law. Medical education. Volume Issue 8 Suppl. Med J Aust ; 8 : SS Published online: 19 October Topics Health services administration. Synopsis The introduction of casemix funding systems has focused attention on the reliability and validity of coded health data. Defining and classifying medical and health related terms are the core activities of the National Centre for Classification in Health NCCH , which has recently published the Australian modification of the International statistical classification of diseases and health related problems, 10th revision ICDAM.
Clinicians have made major contributions to the new classification through a network of 21 Clinical Coding and Classification Groups, which advise the NCCH. Major advantages of ICDAM for clinicians include the ability to update the classification within Australia with continued clinical consultation, the familiarity of the procedure codes based on MBS, and the possibility of having one classification for use in public and private healthcare facilities.
Introduction Codes for diseases and procedures are the basic ingredients of the casemix recipe. However, the coding function was not invented for casemix. The need to classify and measure has been around for centuries Box 1. Allied to this need to impose order by classifying is the need to define the elements of a disease or procedure so that the meaning is clear and classification can take place.
O'Rourke highlighted the importance of the meaning of medical terms in the context of doctor-patient communication in cardiology.
The NCCH develops codes and coding standards for use in Australian health services, publishes in hard copy and electronically, and educates clinical coders and clinicians in the application of codes. An important feature is the addition of a classification of procedures based on the Commonwealth Medicare Benefits Schedule MBS of fees for health services.
It was a deliberate decision of the Casemix Implementation Project Board in to create this Australian procedure classification based on the fee schedule so that the classification of procedures in the public and private sectors, as well as in ambulatory situations, would be more consistent.
Codes have been added for procedures not currently eligible for benefits, such as cosmetic surgery, obstetrics and allied health procedures. Casemix classification and mapping Construction of casemix classifications requires data expressed in the source coding systems.
Mappings for grouping purposes are known as "logical" mappings, while those for longitudinal epidemiological studies are called "historical" mappings. The slight differences between these mappings arise because of differences in specificity of the classifications, especially in situations where one code in the new classification maps to many codes in the previous classification, and the many codes are spread over many DRGs Box 3.
Interaction between clinicians and clinical coders The need for accurate decisions on principal diagnosis and code allocation has led to collaboration between clinical coders and clinicians to interpret the documentation in the clinical record and to come to an agreed decision on appropriate codes for episodes of care.
Conclusion Considerable effort has always been devoted to coding diseases and procedures in hospitals. Casemix funding systems with their reliance on accurate classification of diseases and procedures provide a major incentive to getting the data right. Systems are in place through the ICDAM codes, the Australian Coding Standards, the clinical coder workforce, and through input from clinicians to ensure that coding is clinically appropriate, efficient, accurate and timely.
Medicine: An illustrated history. New York: Harry N Abrams, History of the development of the ICD. In: World Health Organization. International statistical classification of diseases and related health problems.
Vol 2, Ch 6. Geneva: WHO, O'Rourke MF. What's in a name? Med J Aust ; Standard nomenclature of diseases and operations. National Centre for Classification in Health. The international statistical classification of diseases and related health problems, 10th revision, Australian modification ICDAM. ICDAM impact assessment project. Final report. First Name. Middle Name.
Last Name. Do you have any competing interests to declare? Yes Competing interests. The ICD view uses the same functions as described in the section about the SNOMED CT view : You can use the text field to do filter searches, displays filter results hierarchically, link with the open editor, set a concept as the root node, return to the default root node, etc.
ICD view showing filter search on 'infarct'. Double-click any of the nodes to open the code in a read-only editor. The Overview tab displays the code, the label and the descriptions and the inclusion and exclusion codes with hyperlinks. ICD editor. The other tabs display details about mappings or value domains that reference the code. ICD editor displaying value domain membership.
The search is not case sensitive.
0コメント