与ICD-9-CM相比,ICD-10-CM中对门诊护理代码特异性的利用进行了检查:对ICD-11实施的影响
Susan H Fenton1, Cassandra Ciminello2, Vickie M Mays3
1Department of Clinical & Health Informatics, McWilliams School of Biomedical Informatics, UTHealth Houston, Houston, TX 77030, United States.
国际疾病分类,第十次修订,临床修改 (ICD-10-CM) 显示在门诊护理中详细代码的利用率很低. 尽管特异性增加,但未指定的代码显著增加,质疑更复杂的编码系统的合理性.
科学领域:
- 医疗信息学 医疗信息学
- 医疗编码系统 医学编码系统
- 医疗保健数据分析数据分析
背景情况:
- 国际疾病分类,第十次修订,临床修改 (ICD-10-CM) 实施,以提高数据的特异性与其前身ICD-9-CM相比.
- 一个主要目标是改善医疗分析和报告的详细临床数据的可用性.
研究的目的:
- 评估ICD-10-CM系统在门诊护理环境中增加特异性的利用情况.
- 为未来在美国实施ICD-11内容的基于证据的评估提供信息.
主要方法:
- 来自2014年 (ICD-9-CM) 和2019年 (ICD-10-CM) IQVIA门诊EMR-US数据库25%随机样本的诊断代码和描述的分析.
- 评估代码使用率,包括使用的总和唯一代码,以及两种系统中未指定的代码的比例.
主要成果:
- 只有44.6%的可用ICD-10-CM代码被使用,而ICD-9-CM代码的使用率为91.5%.
- 不确定代码的百分比从14.5% (ICD-9-CM) 增加到33.3% (ICD-10-CM).
结论:
- 尽管ICD-10-CM具有更大的细节性,但在ICD-10-CM中观察到未指定的代码 (108.5%) 的使用显著增加.
- 目前的使用模式并不完全支持ICD-10-CM代码量大幅增加的理由.
- 可能需要先进的技术和方法来有效地利用像ICD-10-CM这样的复杂分类系统中的详细信息,以及未来的ICD-11评估.
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