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目的调查艾滋病编码现状,对编码错误原因进行分析,旨在提高艾滋病编码的准确率。方法回顾性调查某院2015年收治的艾滋病病案713份,逐份对疾病编码进行审核分析,归纳出4种错误类型并进行百分比统计。结果 713份病案编码错误达76份,占10.7%。其中编码逻辑错误35份,占46.1%;合并编码错误24份,占31.6%;综合编码错误10份,占13.2%;选择编码错误7份,占9.2%。结论注意审核编码之间逻辑关系;艾滋病与并发症要合并编码,但编码HIV发生之前已存在的疾病时,该疾病要分开编码,且这个疾病应作为附加编码;主要诊断注意综合编码.7的运用;根据艾滋病分期概念正确选择对应编码,慎用B24。
Objective To investigate the status of HIV / AIDS codes and to analyze the causes of coding errors so as to improve the accuracy of AIDS codes. Methods A retrospective survey of 713 HIV / AIDS cases admitted to a hospital in 2015 was conducted to review and analyze the disease codes one by one, and the four types of errors were summarized and percentage statistics were collected. Results There were 76 errors in 713 cases, accounting for 10.7%. Among them, 35 were coding logic errors, accounting for 46.1%; 24 were combined coding errors, accounting for 31.6%; 10 were synthetic coding errors, accounting for 13.2%; and 7 were coding errors, accounting for 9.2%. CONCLUSIONS Attention should be paid to reviewing the logical relationship between coding; AIDS and complication should be combined with coding, but coding for a pre-HIV existing disease should be coded separately and the disease should be treated as an additional coding; Use; according to the concept of AIDS staging the correct choice of the corresponding coding, be careful B24.