Analysis on Morphological Coding Problems in Lung Neuroendocrine Neoplasms
Objectives To verify the morphological coding of lung neuroendocrine tumors in a Three A and Tertiary Hospital,analyze the causes of errors,and propose corresponding quality control improvement measures to improve the accuracy of morphological coding.Methods A total of 121 medical records which had the main discharge diagnostic ICD-10 codes of C34,the main surgical ICD-9-CM-3 codes of 32.2-32.5 and pathological diagnosis of neuroendocrine neoplasms,were retrieved from the hospital medical record information system from January 1st,2022 to December 31st,2022.The morphological coding was checked.Results The proportion of small cell carcinoma in 121 cases of lung neuroendocrine tumors was the highest,accounting for 48.8%.There were 26 cases of morphological coding errors,and the pathological types with a high proportion of coding errors were large cell neuroendocrine carcinoma,small cell carcinoma,combined small cell-large cell carcinoma,and atypical carcinoid,with 26.9%,19.2%,15.4%and 15.4%,respectively.The main reasons for morphological coding errors were coding based on frozen pathological results,lack of pathological knowledge,and delayed updating of coding knowledge,with errors accounting for 34.6%,34.6%and 30.8%,respectively.Conclusions The error proportion of morphological coding in lung neuroendocrine neoplasms was relatively high.Coders needed to improve the quality of morphological coding in lung neuroendocrine neoplasms by enhancing their learning of pathological classification knowledge,comprehensively utilizing different morphological coding versions,and utilizing information technology.
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