Chapters in ICPC-2 |
|
Common
error in coding ICPC-2 |
|
A General |
|
|
Hyperuricaemia was
incorrectly coded as gouty arthritis (T92). Hyperuricaemia should
be coded as A91 (abnormal result investigation number). |
|
|
|
Adverse effect of
medical agent (A85) was not coded correctly. e.g. ACEI induced
cough was incorrectly coded as cough (R05). |
|
|
|
|
B Blood/blood forming
organs/immune mechanism |
|
|
nil |
|
|
|
|
D Digestive |
|
|
Diagnoses of gastroenteritis
was coded as D11 (diarrhoea) while D73 (gastroenteritis presumed
infective origin) should be more specific. |
|
|
|
Confusion with coding
disease presented with jaundice and was non-specifically coded
as jaundice (D13). Codes specifically on the diagnoses are more
appropriate e.g. viral hepatitis (D72), hepatocellular carcinoma
(D77), pancreatic cancer (D76). |
|
|
|
Patients presented
with chronic hepatitis B infection were not coded. Viral hepatitis
(D72) should be used which include all hepatitis presumed viral
and chronic active hepatitis. The criteria are "evidence
of viral infection with inflammation of the liver with or without
jaundice; or serological evidence of an infection with a hepatitis
virus". |
|
|
|
In patients with epigastric
pain, it appears that many codes could be used which was frequently
confused. If one could arrive at a diagnosis, e.g. duodenal
ulcer (D85), Peptic ulcer other (D86), one could code such diagnoses.
Frequently, before one could arrive at a specific diagnosis,
the symptom/complaint or "Reason for Encounter" (RFE)
could be coded. Therefore when patient says, |
|
|
|
|
"I have stomach ache and
pain" D02 |
|
|
|
|
"I am dyspeptic." D07
|
|
|
|
|
"I am bloating and passing
wind" D08 |
|
|
|
|
"I have pain over here"
(pointing at his epigastrium) D02 |
|
|
|
|
|
F Eye |
|
|
Subconjunctival haemorrhage
was incorrectly coded as red eye(F02) which should be coded
as F75 (Contusion/haemorrhage eye). |
|
|
|
|
K Circulatory |
|
|
Hypertension (HT)
with complications was incorrectly coded as K86. In ICPC-2 codes
K85-K87 are related to hypertension. K85 is used for elevated
blood pressure not meeting criteria for K86 and K87 and transient
or labile hypertension. This could be used in patients with
elevated BP awaiting confirmation of diagnoses and in patients
with transient increase in BP with existing HT. In confirmed
HT patients with essential HT, HT NOS and idiopathic HT, K86
should be used. If complications occurred in HT patients, K87
should be used i.e. HT abnormalities of the heart, kidney, eye
or brain attributed to HT. |
|
|
|
Internal haemorrhoid
or perianal haematoma was wrongly coded as digestive symptom.
In ICPC-2, they are coded under circulatory problem, K96. |
|
|
|
|
L Musculoskeletal |
|
|
Codes for symptoms
were frequently misused while the diagnosis was not coded specifically.
|
|
|
|
Osteoarthritis of
knee was incorrectly coded as L15 (knee symptom/complaint) while
L90 (osteoarthritis of knee) was more specific. |
|
|
|
Flat foot was incorrectly
coded as L17 (Foot/toe complaint) while L98 (acquired deformity
of limb) was more specific. |
|
|
|
Frozen shoulder was
coded incorrectly as L08 (shoulder symptom/complaint) while
L92 (shoulder syndrome) was more specific. |
|
|
|
De Quervain syndrome
was incorrectly coded as L11 (wrist symptom/complaint) while
L87 (bursitis/tendinitis/synovitis) should be used. |
|
|
|
|
N Neurological |
|
|
Carpal tunnel syndrome
was incorrectly coded as L12 (hand symptom/complaint) which
should be coded as N93 (carpal tunnel syndrome). |
|
|
|
|
P Psychological |
|
|
Many psychological
problems were encountered but not coded. |
|
|
|
Panic attack/disorder
was incorrectly coded as P99 (psychological disorders other)
which should be specifically coded as P74 (anxiety disorder/anxiety
state) |
|
|
|
Obstructive sleep
apnoea was erroneously coded as respiratory problem. In ICPC-2,
P06 (Sleep disturbance) should be used. |
|
|
|
|
R Respiratory |
|
|
Hyperactive airway
was coded incorrectly as R05 (cough) while this should be code
as R96 (asthma). |
|
|
|
|
S Skin |
|
|
Dry skin was coded
incorrectly as S29 (skin symptom/complaint other) which should
be coded as S21 (skin texture symptom/complaint) |
|
|
|
|
T Endocrine/metabolic/nutritional |
|
|
Obesity is classified
differently in Asians and Caucasians; and T82 (Obesity) and
T83 (Overweight) seem to mean different things in Asians and
cause confusion in coding. We adopted WHO Asia Pacific perspective
in our coding for Asians (WHO IOTF 2003): (Table
3) |
|
|
|
|
U Urinary
system |
|
|
Nil |
|
|
|
|
W Pregnancy, childbearing,
family planning |
|
|
Nil |
|
|
|
|
X Female genital system
including breast |
|
|
Nil |
|
|
|
|
Y Male genital system |
|
|
Male breast lump was
wrongly coded as including breast X19 (breast lump/mass female).
Y16 (breast symptom/complaint male) should be used while equivalent
code in female was X19 |
|
|
|
|
Z Social problems |
|
|
Social problems were
frequently not coded |
|
|
|
Loss of parents was
coded wrongly as P06 (sleep disturbance) while it should be
coded as Z23(loss/death of parent/family member problem) |