Q1. Please write below what you use for manual coding (e.g., ICD 10 2016) and which computer programme you use on a clinical discharge summary for HES statistics.
Manual: We use the ICD-10 5th Edition, 10th Revision, 2016 for diagnostic coding purposes.
Programme:
Q2. Please tell us how you would code the following diseases. If you have a computer programme for coding, please code it manually and with the programme. Please include all relevant information (e.g., Multiple possible codes depending on context). No computer programme for coding. All diagnostic inpatient coding done manually. Conditions are coded as per the trails in the ICD-10 index which is in the public domain.
Disease
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Computer ICD 10 coding
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Manual ICD 10 coding
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Example
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G20
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Progressive Supranuclear Palsy
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G23.1 Progressive supranuclera ophthalmoplegia (Steele-Richardson-Olszewski)
Progressive supranuclear palsy
G23.1 is the code as per the trail:
Palsy (see also paralysis) G83.9
-supranuclear (progressive) G23.1
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Multiple system atrophy
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G23.2 Multiple System atrophy, parkinsonian type (MSA-P)
G23.2 Multiple system atrophy, cerebellar type (MSA-C)
G23.2 is the default trail for an unspecified MSA and G23.3 for MSA of cerebellar type, as per the trail:
Atrophy,atrophic
-multiple (multi-)system (brain) (CNS) (parkinsonian type) (MSA-P) G23.2
--cerebellar type (MSA-C) G23.3
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Corticobasal syndrome
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No direct trail in current version of ICD-10 for either condition. We currently code Corticobasal ganglionic degeneration / Corticobasal syndrome as:
G31.8 Other specified degenerative diseases of nervous system
Grey-matter degeneration (Alpers)
Lewy body(ies)(dementia)(disease) (F02.8*)
Subacute necrotizing encephalopathy (Leigh)
The assignment of G31.8 is based on the following index trail:
Degeneration, degenerative
-nervous system G31.9
--alcoholic G31.2
--amyloid E85.4 G99.8
--autonomic G90.9
--fatty G31.8
--specified NEC G31.8
This is based on local guidance that these are synonyms for the a specified type of degeneration of the nervous system.
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Corticobasal degeneration
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Q3. Please indicate whether any of the clinical coding was different before 2016.
Codes would be as per the trails in each previous edition of ICD-10, the indexes / trails for these conditions and tables of coding equivalence are in the public domain and widely available. It is possible that these trails have changed from previous editions of ICD-10 and as ICD-10 is a classification, it is possible that each code covers more than one condition (i.e. the codes are not specific to the requested disorder).
Disease
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Computer ICD 10 coding
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Manual ICD 10 coding
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Progressive Supranuclear Palsy
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As per trail in relevant edition of ICD-10. An includes note for this condition was included for the first time in ICD-10 for the 2014 edition due to a previously incorrect trail to the following code for this condition:
G12.2 Motor Neuron Disease
Familial motor neuron disease
Lateral sclerosis:
-amyotrophic
-primary
Progressive:
-bulbar palsy
-spinal muscular atrophy
Trail:
PalsyIbulbar (chronic) (progressive)Isupranuclear NEC G12.2
It is possible that some PSP patients may have been coded as G12.2 prior to the trail / includes note in the 2014 edition. This was an international update to ICD-10 by the WHO.
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Multiple system atrophy
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As per trail in relevant edition of ICD-10. G23.2 / G23.3 are new codes in the latest edition and this condition previously (all previous editions) trailed to:
G90.3 Multi-system degeneration
Neurogenic orthostatic hypotension (Shy-Drager)
Excl: orthostatic hypotension NOS (I95.1)
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Corticobasal syndrome
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As per trail in relevant edition of ICD-10. No trail in previous editions (see local guidance above).
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Corticobasal degeneration
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As per trail in relevant edition of ICD-10. No trail in previous editions (see local guidance above).
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It should also be noted that ICD-11 (not mandated yet) has the following trails / codes for these conditions:
Progressive Supranuclear Palsy / Corticobasal syndrome / Corticobasal degeneration (all within category for Atypical parkinsonism 8A00.1)
8A00.10 – Progressive supranuclear palsy (Includes: Progressive supranuclear palsy – corticobasal syndrome)
8A00.1Y – Atypical Parkinsonism (Includes: Corticobasal Degeneration / CBD)
Multiple system atrophy
8D87.00 – MSA, Cerbellar type
8D87.01 - MSA, Parkinsonism
8D87.0Y – Other specified MSA
8D87.0Z – Unspecified MSA