Coding of female genital mutilation in the French Program for Medical Information Systems (PMSI): Why and how to improve accuracy?

This study aims to analyze the coding practices of female genital mutilation (FGM) within the French Program for Medical Information Systems (PMSI) in order to identify current limitations and their impact on care classification and healthcare funding.

A mixed-methods approach was adopted, combining a qualitative analysis based on a semi-structured interview with a specialist physician and an exploratory quantitative analysis based on a questionnaire distributed to Medical Information Departments (DIM). Data analysis relied on descriptive and comparative methods.

All surveyed Medical Information Departments use the ICD-10 code N90.8 to code FGM as the principal diagnosis. However, practices vary significantly regarding associated diagnoses and surgical procedures. The lack of harmonization in coding practices, as well as limited awareness of specific funding mechanisms, restricts access to dedicated financial support for FGM management.

This study highlights the urgent need to improve FGM coding within the PMSI through the adoption of more specific codes. Better data structuring and traceability would improve recognition of care needs and facilitate access to funding mechanisms such as MIGAC and MERRI, thereby enhancing the quality of care provided to patients.