摘要
胃癌相关手术包括早期胃癌的病损切除术、进展期胃癌的根治性切除术和姑息性手术。早期胃癌主要采用内镜下切除术,编码为43.41;进展期胃癌根治术则根据临床术式、切除的部位、范围以及消化道重建方式来确定编码,编码范围43.5-43.9;姑息性手术主要为不伴胃切除术的胃肠吻合术,编码44.38-44.39。本文通过对胃癌相关临床术式与ICD-9-CM-3中的编码规则进行比较和分析,结合具体案例探讨胃癌相关手术治疗方式的编码。编码员在分类胃癌相关手术时,首先需明确具体手术方式,是内镜下切除术还是外科根治性手术或姑息性手术,其次分析手术切除的部位和范围,是近端胃、远端胃还是全胃切除,最后剖析消化道的重建方式,是BillrothⅠ式吻合法、BillrothⅡ式吻合法、食管胃吻合法还是其他的吻合方法。
Gastric cancer-related surgery includes lesion resection for early gastric cancer,radical resection for advanced gastric cancer and palliative surgery.Endoscopic resection was the main method for early gastric cancer,with the code of 43.41.For radical gastrectomy of advanced gastric cancer,the coding was determined according to the clinical operation type,the site and scope of resection,and the reconstruction method of digestive tract,with the coding range of 43.5-43.9.Palliative surgery is mainly gastroenterostomy without gastrectomy,coded as 44.38-44.39.In this paper,by comparing and analyzing the coding rules of gastric cancer-related clinical operation methods and ICD-9-CM-3,the coding of gastric cancer-related surgical treatment methods was discussed in combination with specific cases.Coder in the classification of stomach cancer surgery,you need to clear the specific operation method,endoscopic resection or the surgical radical operation or palliative surgery,followed by analysis of the region and the scope of surgical resection,distal proximal stomach,the stomach or full stomach resection,finally analyze the way of the reconstruction of the digestive tract,is BillrothⅠtype anastomosis method,BillrothⅡtype match method,the stomach esophagus anastomosis method or other methods of anastomosis.
作者
李新美
冯启明
Li Xinmei;Feng Qiming(The Affiliated Tumor Hospital of Guangxi Medical University,Nanning 530021,Guangxi Zhuang Autonomous Region,China;不详)
出处
《中国病案》
2021年第7期43-45,共3页
Chinese Medical Record
基金
广西壮族自治区卫生健康委员会自筹经费科研课题(Z20190386)。
