DRG coding guidelinesMDC1、4、5、6、7、10、11.pptVIP

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DRG coding guidelinesMDC1、4、5、6、7、10、11.ppt

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DRG coding guidelinesMDC1、4、5、6、7、10、11 台北榮總醫務企管部病歷組魏秀美於台灣地區醫院協會2006-10-09 16 DRG Validation Case-Mix Index Complication/Comorbidity DRG percentage High-Risk DRGs Highest-Volume DRGs Problematic Diagnosis or procedure Variations in Length of stay and in charges Excludes An excludes note under a code indicate that the terms excluded from the code are to be coded elsewhere. In some cases the codes for the excluded terms should not be used in conjunction with the code from which it is excluded. An example of this is a congenital condition excluded from an acquired form of the same condition. The congenital and acquired codes should not be used together. In other cases, the excluded terms may be used together with an excluded code. An example of this is when fractures of different bones are coded to different codes. Both codes may be used together if both types of fractures are present. ICD-9-CM Official Guidelines For Coding and Reporting Cerebrovascular disease, CVA Cerebrovascular disease 430~438 Includes： with mention of hypertension (conditions classifiable to 401~405) Use additional code, if desired, to identify presence of hypertension ICD-9-CM 2001 Tabular list CVA-Hemorrhage Infarction / Hemiplegia / Aphasia Code 430~437 use of additional codes to identify any sequelse. Acute cerebral artery occlusion with infarction with sequelse of hemiplegia and aphasia 434.91+342.90+784.3 Coding clinic, 4Q,1998, p.87 A history of cerebral artery occlusion with infarction with residuals hemiplegia and aphasia is coded 438.20+438.11 Coding clinic, 4Q,1998, p.39~40 Embolic hemorrhagic infarct Embolic hemorrhagic infarct of the temporal lobe is coded 434.11, The hemorrhage is considered a component of the occlusion so code 431, Intracerebral hemorrhage is not used as an additional code. Coding clinic, 3Q,1997, p.11 Brain stem stroke Brain stem stroke is coded 434.91 Coding clinic, 4Q,2004, p.77~78 Lacunar infarction An acute lacunar infarction is coded 43