「特約醫院ICD-10-CM/ PCS小型先驅計畫」 結案報告書

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行政院衛生署中央健保局委託辦理 「特約醫院 ICD-10-CM/ PCS小型先驅計畫」 結案報告書 執 行 機 構:三軍總醫院附設民眾診療服務處 執 行 期 間:100.12.29 - 101.12.28 人:陳建同

Transcript of 「特約醫院ICD-10-CM/ PCS小型先驅計畫」 結案報告書

  • ICD-10-CM/ PCS

    100.12.29 - 101.12.28

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    1.

    2.

    3.

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    A. ICD-10

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    (a)

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    2. ICD-10-CM/PCS

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    ICD-10-CM/PCS

  • ICD-9-CM 30

    ICD-9 104 ICD-10-CM/PCS ICD-9-CM

    ICD-10

    104 ICD-10-CM/PCS

    1. ICD-10-CM /PCS

    2. ICD-10-CM /PCS

    3. ICD-10-CM /PCS

    4. ICD-10-CM /PCS

    5. ICD-10-CM/PCS

    6.

  • 101 1

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    101 8~9 ICD-10

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    2

    3

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    5

    6

    7

    8

    9

    10

    11

    12

    ICD-10

    ICD-

    10-CM/PCS

    ICD-10-

    CM/ PCS

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    ICD-

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    2ICD-10-

    CM/ PCS

    ICD-10-CM/PCS

    ICD-10-CM/PCS

    101

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    CM/PCS

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  • DRG DRG

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    DRG

    DRG

    DRG

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    ICD-10

    DRG ICD-10

    ICD-10 () ICD-10 ICD-10

  • 101 1 18 ICD-10-CM/

    PCS

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    ICD-10-CM/ PCS

    ICD-10-CM/PCS

    --ICD-10-CM/PCS

    ICD-10-CM/PCS

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    4M

  • Man

    ICD-10CM/PCS

    1. 10 ICD-9 15.25 2. 100/3/25 4/18 ICD-10-CM/PCS 3. 4.ICD-10-CM/PCS ICD-10

    1 101

    ICD-10CM/PCS

    1. DRG 2.

    Method

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    1. 13 ICD-10/PCS ICD-10-CM 2. ICD-10-CM/PCS

    100/3/15 ICD10

    1. ICD-10-PCS 31

    2. ICD-10-CM/PCS8/16 82

    -

    DRG DRG

    DRG DRG DRG

    DRG DRG 95% DRG DRG 90%

    Material

    ICD-10-CM/PCS

  • ICD-9 ICD10

    ICD-10-CM/PCS

    20

    20

    94 99 ICD-10-CM/PCS 20

    ICD-10-CM/PCS

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    ICD-10-CM/PCS ICD-10

    Machine

    ICD-10-CM/PCS

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    IC

    D-10C

    M/P

    CS

    Man

    ICD-10CM/PCS

    95%

    ICD-10

    90%

    1 2ICD-10

    Method

    ICD-10CM/PCS

    ICD-10

    ICD-10

    Material

    ICD-10 ICD-10

    ICD-9 ICD-10

    ICD-9 ICD-10

    Machine

  • Man

    ICD-10CM/PCS

    ICD-10

    ICD-9

    90%

    ICD-10

    Method

    ICD-10

    ICD-10

    ICD-9

    95%

    ICD-10 90%

    Material

    20

    ICD-9

    ICD-10

    20

    Machine

    ()

    ICD-10CM/PCS

    60 60 54 174 O

    ICD-10 40 40 40 120 O

    38 38 38 114 O

    ICD-10 58 60 60 178 O

    ICD-9 ICD-10 40 40 42 122 O

    60 60 60 180 O

    58 60 60 178 O

    5 3 1 12 12 *3 *3 *80%=87

  • ICD-10 60 58 54 172 O

    60 60 60 180 O

    20 58 60 60 178 O

    36 36 38 110 O

  • 3.

    A. (a) ICD-10CM/PCS

    2

    ICD-10

    ICD-10

    ICD-10

    ICD-9 ICD-10

    5 3 1 X0 5

  • 2

    ICD-10

    ICD-10

    ICD-10

    20

    20

    ICD-10

    5 3 1 X0 5

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    (1)

    ICD-10

    ICD-10-CM/ PCS

    ICD-10

    52

    (ICD-10 )

    A. ICD-10

    ICD-9

    ICD-10

    ICD-10

    !

    (100 11 16 )

    300 ICD10

    ICD-10

  • 20

    ICD-10

    B.

    ICD-10 14

    ICD-10PCS

    ICD-10CM ICD-10

    15

    Coding

    C.

    ICD-10-CM/PCS

    ICD-10

    DRG

  • ICD-10

    !

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    1 1010822

    2 1010918 305

    3 1010919 OPH

    4 1010925 305 ICD-10

    5 1010926 OPH

    6 1011009 OPH

    7 1011017 OPH

    8 1011116 305

    9 1011121 305

    10 1011122 305

    11 1011127 305

    D. ICD-10

    ICD-10

    ICD-10 20

    ICD-10

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    1 1010601 CVS ICD-10

    2 1010628 ICD-10

    3 1010704 OPH ICD-10

    4 1010717 OPH ICD-10

    5 1010727 601 ICD-10

    6 1010731 ICD-10 E. ICD-10

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    28-29 ICD-10-CM/PCS

    ICD-10-CM/PCS

    ICD-10-CM/PCS

    101 10

    11 ICD-10-CM/PCS

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    F.

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    //DRG

    ICD-10

    ICD-10

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    ICD-10-CM/PCS

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    101.3.29 101.10.30

    ICD-10 60min/3

    45min/3

  • ( 80%

    100% 83.3% 99.7%)

    ( 70% 100%

    50% 93%)

    ICD-10

    ICD-10

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    100% (ICD-10 )

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    ICD-10-CM/PCS

    ICD-10

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    ICD-10

    ICD-9 ICD-10

    CABG

    ICD-10

    ICD-10-CM

    ICD-10-CM

  • ICD-10/PCS Device Qualifer

  • CABG 20%

    ICD-10

  • ICD-9-CM

  • ( 360-379);(380-389) ICD-10-CM () 80%!

  • ICD-10 3

    3

  • (4)

  • A. --ICD-10

    TPR

    ICD-10

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    ICD-10-PCS

    ICD-10-PCS

    ICD-10-PCS

    CABG

    ICD-10-PCS

    ICD-10-PCS

    ICD-10-PCS

  • B. ICD-9-CM/PCS

    101 8 9

    ICD-10-CM/PCS

  • ICD-9

  • 1. PDCA

    A. ICD-10-CM/PCS

    ICD-10 ICD-10 ICD-9 ICD-10

    100.03.15

    | 101.11.01

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    2. 3. ICD-10

    4. 5. 6. 7. 8. ICD-9 ICD-10

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    3. 4. 5. ICD-10 6.

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    A C 1.

    0%

    50%

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    - 80% 80% 80%

    - 80% 95% 83.33%

    - 80% 90% 100%

    - 95.71% 100% 99.74%

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    0%

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    CVS OPH

    3. ICD-10 100% ()

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    1. ICD-10 2. 3. 20 4.

    100.03.15 |

    101.11.01

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  • 2. ICD-10-CM/PCS

    101 8~9 ICD-10-CM/PCS 531 ICD-9 ICD10-CM/PCS

    ICD-10-CM/PCS 10108 10109

    CVS 102 80 182 NEU 93 99 192 OPH 92 65 157 287 244 531

  • 20 ICD-10-CM

    T82 Complications of cardiac and vascularprostetic devices implants and grafts

    I83 Varicose veins of lower extremities I25 Chronic ischemic heart disease

    I21 ST elevation (STEMI) and non-ST elevation(NSTEMI) myocardial infarctionST (STEMISTNSTEMI

    I71 Aortic aneurysm dissection I87 Other disorders of veins I74 Arterial embolism and thrombosis I82 Other venous embolism and thrombosis I08 Multiple valve diseases I34 Nonrheumatic mitral valve disorders I50 Heart failure

    Z09Encounter for follow-up examination aftercompleted treatment for conditions other thanmalignant neoplasm

    E11 Type 2 diabetes mellitus 2I05 Rheumatic mitral valve diseases I12 Hypertensive chronic kidney disease I13 Hypertensive heart and chronic kidney disease I33 Acute and subacute endocarditis I77 Other disorders of arteries and arterioles

    I97Intraoperative and postproceduralcomplications and disorders of circulatorysystem, not elsewhere classified

    K52 Other and unspecified noninfectivegastroenteritis and colitis

  • I63 Cerebral infarction

    G45 Transient cerebral ischemic attacks andrelated syndromes

    I69 Sequelae of cerebrovascular disease G40 Epilepsy and recurrent seizures G61 Inflammatory polyneuropathy F01 Vascular dementia G20 Parkinson's disease G43 Migraine

    M51 Thoracic, thoracolumbar, and lumbosacralintervertebral disc disorders

    R42 Dizziness and giddiness E11 Type 2 diabetes mellitus 2E88 Other and unspecified metabolic disorders G03 Meningitis due to other and unspecified causes G35 Multiple sclerosis G90 Disorders of autonomic nervous system H81 Disorders of vestibular function J18 Pneumonia, unspecified organism M48 Other spondylopathies M50 Cervical disc disorders

    R41 Other symptoms and signs involving cognitivefunctions and awareness

    H40 Glaucoma H33 Retinal detachments and breaks E11 Type 2 diabetes mellitus 2H25 Age-related cataract H35 Other retinal disorders H18 Other disorders of cornea H50 Other strabismus H43 Disorders of vitreous body H44 Disorders of globe S05 Injury of eye and orbit

    T86 Complications of transplanted organs andtissue

    H11 Other disorders of conjunctiva H17 Corneal scars and opacities

    Q10 Congenital malformations of eyelid, lacrimalapparatus and orbit

    Q15 Other congenital malformations of eye E88 Other and unspecified metabolic disorders H21 Other disorders of iris and ciliary body H31 Other disorders of choroid H46 Optic neuritis

    H47 Other disorders of optic [2nd] nerve and visualpathways (2)

  • 20 ICD-10-PCS ICD-10 ICD-10

    4A023N7 Measurement of Cardiac Sampling andPressure, Left Heart, Percutaneous Approach

    02100Z9 Bypass Coronary Artery, One Site to Left InternalMammary, Open Approach

    027034ZDilation of Coronary Artery, One Site with Drug-eluting Intraluminal Device, PercutaneousApproach

    02RF0JZ Replacement of Aortic Valve with SyntheticSubstitute, Open Approach

    06DQ0ZZ Extraction of Left Greater Saphenous Vein,Open Approach

    021009W Bypass Coronary Artery, One Site to Aorta withAutologous Venous Tissue, Open Approach

    021209W Bypass Coronary Artery, Three Sites to Aortawith Autologous Venous Tissue, Open Approach

    03180JD Bypass Left Brachial Artery to Upper Arm Veinwith Synthetic Substitute, Open Approach

    06DQ3ZZ Extraction of Left Greater Saphenous Vein,Percutaneous Approach

    021109W Bypass Coronary Artery, Two Sites to Aorta withAutologous Venous Tissue, Open Approach

    02RG0JZ Replacement of Mitral Valve with SyntheticSubstitute, Open Approach

    03170JD Bypass Right Brachial Artery to Upper Arm Veinwith Synthetic Substitute, Open Approach

    04V03DZ Restriction of Abdominal Aorta with IntraluminalDevice, Percutaneous Approach

    057F3ZZ Dilation of Left Cephalic Vein, PercutaneousApproach

    06DP3ZZ Extraction of Right Greater Saphenous Vein,Percutaneous Approach

    06HM33Z Insertion of Infusion Device into Right FemoralVein, Percutaneous Approach

    5A1D00Z Performance of Urinary Filtration, Single

    B2031ZZ Plain Radiography of Multiple Coronary ArteryBypass Grafts using Low Osmolar Contrast

  • ICD-10 ICD-10

    B020ZZZ Computerized Tomography (CT Scan) of Brain 5A1D00Z Performance of Urinary Filtration, Single B030ZZZ Magnetic Resonance Imaging (MRI) of Brain

    5A1955Z Respiratory Ventilation, Greater than 96Consecutive Hours 97

    009U3ZX Drainage of Spinal Canal, PercutaneousApproach, Diagnostic

    0B113F4 Bypass Trachea to Cutaneous withTracheostomy Device, Percutaneous Approach, ,

    6A551Z3 Pheresis of Plasma, Multiple

    009T3ZX Drainage of Spinal Meninges, PercutaneousApproach, Diagnostic

    009U30Z Drainage of Spinal Canal with Drainage Device,Percutaneous Approach

    009U3ZZ Drainage of Spinal Canal, PercutaneousApproach

    009Y3ZX Drainage of Lumbar Spinal Cord, PercutaneousApproach, Diagnostic

    03180JF Bypass Left Brachial Artery to Lower Arm Veinwith Synthetic Substitute, Open Approach

    04CD0ZZ Extirpation of Matter from Left Common IliacArtery, Open Approach

    0DBK8ZZ Excision of Ascending Colon, Via Natural orArtificial Opening Endoscopic

    0G9K3ZX Drainage of Thyroid Gland, PercutaneousApproach, Diagnostic

    0KBR0ZX Excision of Left Upper Leg Muscle, OpenApproach, Diagnostic

    0T1B4ZD Bypass Bladder to Cutaneous, PercutaneousEndoscopic Approach

    0UB93ZX Excision of Uterus, Percutaneous Approach,Diagnostic

    0W993ZZ Drainage of Right Pleural Cavity, PercutaneousApproach

  • ICD-10 ICD-10

    08R53JZ Replacement of Left Vitreous with SyntheticSubstitute, Percutaneous Approach

    08133Z4 Bypass Left Anterior Chamber to Sclera,Percutaneous Approach

    08R43JZ Replacement of Right Vitreous with SyntheticSubstitute, Percutaneous Approach

    08123Z4 Bypass Right Anterior Chamber to Sclera,Percutaneous Approach

    08UE3JZ Supplement Right Retina with SyntheticSubstitute, Percutaneous Approach

    08R93KZ Replacement of Left Cornea with NonautologousTissue Substitute, Percutaneous Approach

    08R83KZReplacement of Right Cornea withNonautologous Tissue Substitute, PercutaneousApproach

    08RJ3JZ Replacement of Right Lens with SyntheticSubstitute, Percutaneous Approach

    08RK3JZ Replacement of Left Lens with SyntheticSubstitute, Percutaneous Approach

    08SM3ZZ Reposition Left Extraocular Muscle,Percutaneous Approach

    08UF3JZ Supplement Left Retina with SyntheticSubstitute, Percutaneous Approach

    08B53ZZ Excision of Left Vitreous, PercutaneousApproach

    08DK3ZZ Extraction of Left Lens, Percutaneous Approach

    08123J4 Bypass Right Anterior Chamber to Sclera withSynthetic Substitute, Percutaneous Approach

    08133J4 Bypass Left Anterior Chamber to Sclera withSynthetic Substitute, Percutaneous Approach

    08DJ3ZZ Extraction of Right Lens, PercutaneousApproach

    08SL0ZZ Reposition Right Extraocular Muscle, OpenApproach

    08SM0ZZ Reposition Left Extraocular Muscle, OpenApproach

    08T43ZZ Resection of Right Vitreous, PercutaneousApproach

    08B43ZZ Excision of Right Vitreous, PercutaneousApproach

  • ()

    ICD-10

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    98 ICD-10

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    DRG

    99 DRGs

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    ICD-10-CM/PCS

    ICD-10-PCS

    ICD-10-CM/PCS 104

    ICD-10-CM/PCS

    ICD-10

  • DRG

    ICD-10-CM/PCS

    ICD-9

    20 ICD-10

    ICD-10

  • DRG

    ICD-10-PCS

    HIS ICD-10-CM/PCS

    HIS

    ICD-10-CM/PCS

    -

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    1.

    -

  • DRG

    2.

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  • 102

    ICD-10

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    A 1001116 ICD-10

    A 1010216 ICD10

    E ,,

    1010728-

    1010729 ICD-10-CM/PCS

    E 1011011 ICD-10-CM/PCS

    C 1010822

    C 1010918 305

    C 1010925 305 ICD-10

    C 1010919 OPH

    C 1010926 OPH

    C 1011009 OPH

    C 1011017 OPH

    C 1011116 305

    C 1011121 305

    C 1011122 305

    C 1011127 305

    D 1010601 CVS ICD-10

    D 1010628 ICD-10

    D 1010704 OPH ICD-10

    D 1010717 OPH ICD-10

    D 1010727 601 ICD-10

    D 1010731 ICD-10

    B 1000315 305

    B 1000322 305 Root operations that take out someor all of a body part

    B 1000329 305 Root operations that take out someor all of a body part

    B 1000419 305Root operations that take outsolids/fluids/gases from a bodypart cutting or separation only

    B 1000426 305Root operations that take outsolids/fluids/gases from a bodypart cutting or separation only

    B 1000517 305 Root operations that put in/put backor move some/all of a body part

    B 1000524 305 Root operations that alter thediameter/route of a tubular body part

    100-101ICD-10

  • /

    100-101ICD-10

    B 1000531 305 Root operations that always involvea device

    B 1000614 305 Root operations that always involvea device

    B 1000621 305Root operations involvingexamination only other repairsobjectives examination only

    B 1000628 305 Medical and Surgical-relatedsections of ICD-10-PCSAncillary sections in ICD-10-PCS

    B 1000719 305 ICD-10-CM

    B 1000726 305 ICD-10-CM

    B 1000816 305 CODING

    B 1000823 305 CODING

    B 1000830 305 CODING

    B 1000920 305 CODING

    B 1000927 305 CODING

    B 1001018 305 CODING

    B 1001025 305 CODING

    B 1001115 305 CODING

    B 1001122 305 CODING

    B 1001129 305 CODING

    B 1010321 305 ICD-10

    B 1010329 305

    B 1011030 305

    B 1010417 CODING

    B 1010424 CODING

    B 1010522 CODING

    B 1010529 CODING

    B 1010517

    -1010519

    ICD-10-CM/PCS

    1.pdf2345678ICD-10-