ACHI development and principles

1. ACHI development and principles Linda Best 10.45 - 11.30 Tuesday, 6th December 2011

2. Australian Classification of Health Interventions – ACHI WHO ICD-10 does not have a companion intervention classification An Australian intervention classification was produced to be used in conjunction with ICD-10-AM (Australian modification) Self-contained classification based on a fee schedule (MBS)

3. Australian Classification of Health Interventions – ACHI cont. • Contains codes for surgical operations, medical procedures, allied health and dental interventions • Codes are numeric only – five digits with a two digit extension

4. Structure of ACHI • Numbering system and blocks • Code numbers not in numerical order • Block numbers are used to aggregate codes • Blocks in numerical order, to help find codes

5. Structure of ACHI cont. • Multi-axial structure, three axes: • Primary axis – site • Secondary axis – procedure type • Tertiary axis – specific site, procedure or technique used

6. Structure of ACHI cont. • For example: Eardrum and middle ear Examination 41629-00 Exploration of middle ear 41650-00 Inspection of tympanic membrane, unilateral Application, insertion, removal 41647-00 Ear toilette, unilateral Incision 41626-00 Myringotomy, unilateral 41632-00 Myringotomy with insertion of tube, unilateral Type of procedure

7. Structure of ACHI cont. The first five characters represent the MBS item number: 42773Detached retina, diathermy or cryotherapy for 42773-00Repair of retinal detachment by diathermy 42773-01Repair of retinal detachment by cryotherapy The last two characters are allocated for each new procedural concept derived from the MBS item description

8. Structure of ACHI cont. • Exceptions: • Dental • Obstetrics • Radiation oncology • Imaging and miscellaneous procedures

9. Coding procedures with ACHI • Conventions used in Tabular List of Interventions –  ACS 0040 • Same as those for diseases • essential and nonessential modifiers • NEC – not elsewhere classified • ‘see’ and ‘see also’

10. Coding procedures with ACHI cont. • Conventions used in Tabular List of Interventions –  ACS 0040 (cont) • New or different: • includes notes – refers to procedural components or equipment used that is inherent in the description of a code or block heading or may further define the site • and/or in code titles – ‘and’ means and, ‘or’ means or. 59903-00 [607] Left ventriculography 59903-01 [607] Right ventriculography 59903-02 [607] Left and right ventriculography

11. Codingprocedures with ACHI cont. • Conventions used in Tabular List of Interventions –  ACS 0040 (cont) • ‘Omit code’ – instruction in index next to procedures that are an operative approach, e.g. laparotomy for resection of bowel. • ‘see block’ – instruction that you must go to the Tabular List and look at the codes in the block

12. Process for procedure coding • Three basic steps: • Analyse the documentation used in the record to describe the procedure – main term and modifiers • Locate the main term in the Alphabetic Index, then check the indented modifiers • Verify the code shown in the index by checking it in the Tabular List