The application of ICD coding can be illustrated by considering the example of the recording of a death on a UK death certificate and its incorporation.

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Presentation transcript:

The application of ICD coding can be illustrated by considering the example of the recording of a death on a UK death certificate and its incorporation into official mortality statistics. Cause of death I (a) Disease or condition directly leading to death ………………………………………………………. (b) Other contributory conditions ………………… (c) Leading to I (b)…………………………………. II Other significant conditions contributing to the death but not related to the disease or condition ………………………………………………………..

In this case the patient suffered an episode of acute bronchopneumonia, although the doctor identified their underlying medical condition as being chronic bronchitis Cause of death I (a) Disease or condition directly leading to death ……………acute bronchopneumonia …………. (b) Other contributory conditions ………………… (c) Leading to I (b)…………………………………. II Other significant conditions contributing to the death but not related to the disease or condition …………….. chronic bronchitis ………………….

Cause of death I (a) Disease or condition directly leading to death ……………acute bronchopneumonia …………. (b) Other contributory conditions ………………… (c) Leading to I (b)…………………………………. II Other significant conditions contributing to the death but not related to the disease or condition …………….. chronic bronchitis …………………. This specific diagnosis will be dependent to some extent on the time and place in which it was recorded. Under ICD-9 coding rules the condition leading directly to death would be used for the classification, whereas under ICD-10 coding rules, this is interpreted as the direct consequence of the underlying chronic bronchitis, and the latter will be used for classification

Bronchopneumonia Chronic bronchitis The ICD coding of this underlying condition will be undertaken automatically using text-recognition software. ICD codes are grouped hierarchically by type of condition and in this case, the best match under ICD-9 would be 485: ‘Bronchopneumonia, organism unspecified’ Chronic bronchitis 483 Pneumonia due to other specified organism Pneumonia due to: Eaton's agent Mycoplasma(pneumoniae) Pleuropneumonia-like organisms [PPLO] 485 Bronchopneumonia, organism unspecified Excludes: bronchiolitis (466.1) lipoid pneumonia (507.1) 486 Pneumonia, organism unspecified (coding course: www.cdc.gov)

Bronchopneumonia Chronic bronchitis The ICD-10 coding of the underlying condition falls into ICD-10 chapter X ‘Diseases of the respiratory system’ Within this chapter, there are various subdivisions of chronic bronchitis, but in this case the best match is J42: ‘unspecified chronic bronchitis’ and this will be the ICD code attached to this death. Chronic bronchitis J39.8 Other specified diseases of upper respiratory tract J39.9 Disease of upper respiratory tract, unspecified J40 Bronchitis, not specified as acute or chronic J41 Simple and mucopurulent chronic bronchitis J41.0 Simple chronic bronchitis J41.1 Mucopurulent chronic bronchitis J41.8 Mixed simple and mucopurulent chronic bronchitis J42 Unspecified chronic bronchitis J43 Emphysema J43.0 MacLeod's syndrome (coding course: www.cdc.gov)