Chroniker-Statistik - welche ICDs sind die "hinterlegten" Diagnosen?

Question

Hallo Zollsoft, ich habs gesucht aber leider nicht gefunden. Welche ICD sind für die Chroniker-Statistik (Verwaltung/KV-Abrechnung/--) hinterlegt? Bzgl. kann man die (selbst) anpassen? (Pädiatrie)

Vielen Dank für Infos!

Christian Schröter

Answer 1

Guten Tag Herr Schröter,

es werden alle Diagnosen (auf den Scheinen) aus den letzten 4 Quartalen ausgewertet. Ein Patient zählt genau dann als Chroniker, wenn er in den letzten 4 Quartalen (inklusive dem aktuellen) immer diesselbe Diagnose (ICD-Code) hatte und mindestens 3 Arzt-Patienten-Kontakte vorliegen (Stichwort 4-3-2-1 Regel).

Die ICDs lassen sich nicht selbst anpassen. Wir haben folgende Diagnosen hinterlegt (Regexp-Vergleich mit dem ICD-Code):

{"A1[56789]\\.\\d", "B18\\.\\d", "B2[0124]", "B23\\.\\d", "B9[04]\\.\\d", "B9[12]", "E0[013457]\\.\\d", 
				"E06\\.[123459]", "E1[01234]\\.\\d[\\d-]", "E16\\.[3489]", "E2[012346789]\\.\\d", "E25.0[\\d-]", "E25.[89]",
				"E3[014]\\.\\d", "E32\\.[089]", "E34\\.5[019-]", "E4[35]", "E70\\.\\d", "E8[0345]\\.\\d", "E83\\.[35][\\d-]",
				"E84\\.8[\\d-]", "E88\\.[01289]", "E89.1", "F0[012]\\.\\d", "F0[349]", "F05\\.1", "F06\\.[5678]", "F2[025]\\.\\d",
				"F2[1489]", "F3[134]\\.\\d", "F38\\.[18]", "F39", "F41\\.2", "F44\\.6", "F45.40", "F7[0123489]\\.\\d",
				"F80\\.3", "F84\\.\\d", "F90\\.\\d", "F92\\.0", "F98\\.0", "G1[04]", "G1[123]\\.\\d", "G20\\.\\d[\\d-]", 
				"G21\\.\\d", "G22", "G3[015]\\.\\d", "G31\\.8[\\d-]", "G32.8", "G35\\.[123][\\d-]", "G40\\.0[289-]", 
				"G40\\.[123489]", "G4[17]\\.\\d", "G47\\.3[\\d-]", "G5[034679]\\.\\d", "G6[023]\\.\\d", "G62\\.8[\\d-]",
				"G7[013]\\.\\d", "G72\\.[34]", "G72\\.8[\\d-]", "G8[01]\\.\\d", "G82\\.[0123456][\\d-]", "H28\\.0", "H36\\.0",
				"H40\\.[12345689]", "H42\\.\\d", "H54\\.\\d", "H81\\.0", "H82", "H83\\.3", "H90\\.[023568]", "H91\\.[01389]",
				"H93\\.[012]", "I0[56789]\\.\\d", "I1[01235]\\.\\d\\d", "I25\\.[12]\\d", "I25\\.[0345689]", "I27\\.[0189]", 
				"I27\\.2\\d", "I28\\.\\d", "I3[14567]\\.\\d", "I34\\.8[\\d-]", "I4[12345789]\\.\\d", "I42\\.8[\\d-]",
				"I50\\.[01][\\d-]", "I50\\.9", "I5[12]\\.\\d", "I6[356789]\\.\\d", "I64", "I67\\.[18][\\d-]", "I7[03]\\.\\d",
				"I70\\.2[012345]", "I83\\.\\d", "I87\\.[02][\\d-]", "I88\\.1", "I89\\.\\d", "J4[135]\\.\\d", "J4[267]", 
				"J44\\.[0189][\\d-]", "J6[0145]", "J6[2367]\\.\\d", "J86\\.4", "J70\\.3", "J96\\.1[\\d-]", "K21\\.\\d", 
				"K2[5678]\\.[4567]", "K29\\.[456]", "K5[01]\\.\\d", "K50\\.9[\\d-]", "K57\\.\\d[\\d-]", "K70\\.3", 
				"K7[34]\\.\\d", "K80\\.\\d[\\d-]", "K81\\.1", "K86\\.\\d", "K9[01]\\.\\d", "K91\\.8[08-]", "L20\\.\\d",
				"L40\\.5", "L89\\.\\d[\\d-]", "L97", "L98\\.4", "M02\\.0[\\d-]", "M0[56789]\\.\\d[\\d-]", "M08\\.3",
				"M1[01239]\\.\\d[\\d-]", "M1[45678]\\.\\d", "M3[012345]\\.\\d", "M36\\.[08]", "M4[01236789]\\.\\d[\\d-]",
				"M43\\.\\d", "M45\\.0[\\d-]", "M46\\.1", "M5[01]\\.\\d", "M5[34]\\.\\d", "M5[34]\\.\\d[\\d-]",
				"M61\\.\\d[\\d-]", "M7[25]\\.\\d", "M7[29]\\.\\d[\\d-]", "M8[01278]\\.\\d[\\d-]", "M86\\.[3456][\\d-]",
				"M88\\.0", "M89\\.[06][\\d-]", "M90\\.[01234567][\\d-]", "M90\\.7-", "M9[1234]\\.\\d", "M94\\.\\d[\\d-]",
				"M96\\.[012345]", "N0[345678]\\.\\d", "N1[14]\\.\\d", "N16\\.[123458]", "N18\\.\\d", "N18\\.8[\\d-]",
				"N19", "N25\\.\\d", "N26", "N30\\.[12]", "N31\\.\\d", "N31.8[\\d-]", "N32\\.[0123]", "N33\\.0",
				"N35\\.\\d", "N36\\.[01]", "N39\\.3", "N39\\.4[\\d-]", "N40", "O10\\.\\d", "O11", "O24\\.[0123]", "O98\\.[07]",
				"P27\\.\\d", "P28\\.[01]", "P35\\.0", "Q0[134567]\\.\\d", "Q02", "Q1[123456]\\.\\d", "Q18\\.[0124589]",
				"Q2[01234567]\\.\\d", "Q21\\.8[\\d-]", "Q28\\.[01238][\\d-]", "Q28\\.9", "Q3[012346789]\\.\\d", "Q35\\.[1359]",
				"Q4[01245]\\.\\d", "Q43\\.[12356789]", "Q43\\.4[\\d-]", "Q5[0123456]\\.\\d", "Q6[02]\\.\\d", "Q61\\.[1234589]",
				"Q63\\.[2389]", "Q6[45678]\\.\\d", "Q7[1234789]\\.\\d", "Q75\\.[014589]", "Q76\\.[01346789]", "Q76\\.2[\\d-]",
				"Q8[01245679]\\.\\d", "Q86\\.8[\\d-]", "Q9[01236789]\\.\\d", "Q95\\.[234589]", "R15", "R26\\.3", "R32",
				"52\\.[12]", "T9[0123458]\\.\\d", "T9[67]", "U55\\.[123][\\d-]", "U60\\.\\d", "U61\\.[123]", "U85", "Z21",
				"Z22\\.5", "Z49\\.[12]", "Z75\\.[67][\\d-]", "Z85\\.\\d", "Z86\\.[02345]", "Z89\\.[123456789]", "Z9[0345]\\.\\d",
				"Z92\\.[12346]", "Z9[3456]\\.8[\\d-]", "Z96\\.[0349]", "Z97\\.[18]", "Z98\\.2", "Z99\\.[01234]"}

Wenn ein Patient so als Chroniker identifiziert wurde bestimmt die Chroniker-Statistik Leistungen (03220/1 bzw. 04220/1) die ggf. noch abgerechnet werden können.

Viele Grüsse,

Comments

Hallo Herr Wellegehausen,

vielen Dank für die schonmal hilfreiche Antwort! Das drum herum wusste ich schon - ist aber für "neue KollegenInnen" in dieser Zusammenstellung sehr hilfreich.

Der Inhalt der "Diagnostenliste" war das, was mir nicht bekannt war. Sie ist für "uns PädiaterInnen" nicht ganz so hilfreich - wir werden das mal in unserem Workshopkreis besprechen. Vielleicht kann man da noch die eine oder andere Anpassung machen. Ich werde es dann über Herrn Christoph Baumann und die "pädiatrische TaskForce ;-) weiterleiten.

Herzliche Grüße aus München! Christian Schröter