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CLASSIFICATION & CODING OF MORTALITY & MORBIDITY - AN OVERVIEW

CLASSIFICATION & CODING OF MORTALITY & MORBIDITY - AN OVERVIEW. Dr.Sidhartha Satpathy Assoc Prof, Hosp Admn AIIMS, New-Delhi. Conduct Protocol. Introduction Historical Backdrop ICD-10:salient features Mortality classification-an overview Morbidity classification-an overview

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CLASSIFICATION & CODING OF MORTALITY & MORBIDITY - AN OVERVIEW

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  1. CLASSIFICATION & CODING OF MORTALITY & MORBIDITY- AN OVERVIEW Dr.Sidhartha Satpathy Assoc Prof, Hosp Admn AIIMS, New-Delhi.

  2. Conduct Protocol • Introduction • Historical Backdrop • ICD-10:salient features • Mortality classification-an overview • Morbidity classification-an overview • Some illustrative cases • Conclusion

  3. Introduction • Principle: “People forget, but records remember” • Importance of MR is undisputed esp in light of CPA • Newer legislation- Right to info Act, MOCRA

  4. Historical Backdrop • 18th century- stats classification of COD • 1948-(6R)-non fatal morbidity added • 1975-(9R)- suppl classifications added • 1984-87-(10R)-to develop a family with main ICD as core; alpha-numeric code accepted(1L3N)

  5. ICD-10; Salient Features • Alphanumeric coding- doubled size • Unique letter for majority of chapters • Each of these capable of 100 3ch categories • Letter U kept aside for additions/changes • Chapter titles changed as per contents • New chapters added at appropriate place • Exclusion notes, overviews more lucid • Creation of post procedural condn in some

  6. Mortality classificn: overview • L1-Gen mort (103) • L2-Gen mort (80) • L3-Infant & child mortality (67) • L4-Infant & child mortality (51) • TOTAL= 301 causes

  7. Morbidity classificn overview • Arranged in 21 major chapters • Letter D is associated with Chapter 2&3 • Letter H is associated with Chapter 6&7 • Chapters 1,2,19 & 20 have 2 letters • Each chapter has enough 3 character categories, not all are numbered. • Most 3 ch categories are subdivided by a 4rth numeric ch after decimal point.

  8. Morbidity classfn overview… • Ch I=Infectious & parasitic ds(A00-B99) • Ch II= Neoplasms (C00-D48) • Ch III= Ds in blood & blood forming organs & immune status(D50-89) • Ch IV=Endo, metab & nutrn ds(E00-90) • Ch V=Mental & Behav disorder(F00-99) • Ch VI= Ds of nervous system(G00-99) • Ch VII=Ds of eye & adnexa(H00-59)

  9. Morbidity classfn overview… • Ch VIII=Ds of ear & mastoid(H60-95) • Ch IX=Ds of circulatory system(I00-99) • Ch X=Ds of respiratory system(J00-99) • Ch XI=Ds of digestive system(K00-93) • Ch XII=Ds of skin & subcutaneous (L00-99) • Ch XIII=Ds of musculoskeletal system & connective tissue(M00-99) • Ch XIV= Ds of Genitourinary system(N00-99)

  10. Morbidity classfn overview… • Ch XV=Preg, delivery & puerperium (O00-99) • Ch XVI= Condns in perinatal period(P00-96) • Ch XVII=congenital diseases(Q00-99) • Ch XVIII=S/s & abn clin/lab findings(R00-99) • Ch XIX= Injury, poisoning & consequences of external causes(S00-T98) • Ch XX=External causes of morbidity & mortality (V01-Y98) • Ch XXI= Factors influencing health status & contact with health services(Z00-99)

  11. ICD 10- illustrative cases • Aplastic anemia with mucosal bleed: • D64.9-anemia, NOS • D61.9-AplasticA NOS • Fibroid uterus(intra mural fibroid) • D25.9- leiomyoma of uterus unspecified • D25.2- intramural L

  12. ICD 10- illustrative cases… • Infertility with tubal block • N97.9- female infertility unspecified • N97.1- female infertility-tubal origin • PG at 35 wks with Gestational DM • O00.0- abd pregnancy • O24.4-DM in pregnancy

  13. Partial sensory simple seizure (left) R56.8-Convulsions NOS G40.1-focal/partial symptomatic epilepsy with simple partial seizure Gross hydronephrosis with NFK with UPJO N13.8-other obstructive & reflux uropathy N13.2-hydronephrosis with ureteropelvic junction obstruction ICD 10- illustrative cases…

  14. ICD 10- Problems faced • Incomplete/prov diagnosis by doctors • Use of unfamiliar terminology/ abbrev • Temptation to use NOS category • Lack of exposure to basic tenets

  15. Conclusion • Sensitization to key staff about ICD10 • Training of trainers- cascading effect • Start phased implementation • Regular monitoring & evaluation “A journey of thousand miles starts with a single step.”

  16. Thank you

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