国际疾病分类第十次修订的分析,转诊中心和其他产科医院的编码实践,用于胎盘积分频谱障碍
Savvy Benipal1, Matthew B Givens, Amanda A Allshouse
1Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, and the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Intermountain Healthcare, Murray, Utah; the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York; and the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California.
Obstetrics and gynecology
|April 24, 2025
概括
国际疾病分类,第十次修订 (ICD-10) 代码用于胎盘增殖谱 (PAS) 经常被错误应用,特别是在非转诊医院. 真正的PAS病例在转诊中心和非转诊中心之间对孕产妇发病率没有显著差异.
科学领域:
- 产科和妇科 产科和妇科
- 医学编码准确性 医学编码准确性
- 围产期研究方法学
背景情况:
- 胎盘增生谱 (PAS) 是一个重要的产科并发症.
- 准确的编码对于研究和质量评估至关重要.
- 现有研究强调了PAS的行政数据中的潜在不准确性.
研究的目的:
- 为了评估国际疾病分类的准确性,第十版 (ICD-10) 代码为胎盘增生谱 (PAS).
- 为了确定错误编码PAS诊断的原因.
- 为了比较PAS转诊中心和非转诊产科医院之间的编码准确度和孕产妇发病率.
主要方法:
- 以ICD-10 PAS代码分娩的回顾性队列研究 (2015年9月至2023年12月).
- 由三个审查员进行独立的医疗记录审查,以使用FIGO标准确认真实的PAS.
- 对错误阳性诊断率,错误编码原因和复合孕产妇发病率的分析.
主要成果:
- 39.6%的带有PAS代码的分娩是错误的阳性诊断.
- 在非推中心 (73.6%) 和推中心 (23.8%) 中,错误阳性率明显高.
- 来自其他原因的出血是错误编码的最常见原因;真正的PAS病例在中心类型之间的孕产妇发病率没有显著差异.
结论:
- 对PAS的ICD-10代码经常被错误地应用,特别是在非转介的环境中.
- 尽管转诊中心的疾病严重程度较高,但真正的PAS病例的孕产妇发病率并没有显著差异.
- 调查结果强调了需要改进编码实践和谨慎使用行政数据用于PAS研究和质量指标.
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