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目的探讨国际疾病分类与医疗保险病种付费的关系。方法通过探讨单病种付费、DRGs付费方式,以及国际疾病分类和手术分类在该两种付费方式中的作用,分析国际疾病分类与医保病种付费的关系。结果国际疾病分类在医疗保险按病种付费中起着重要作用,是单病种付费、DRGs付费的基础和依据,编码的准确与否影响着实际付费的多少,疾病分类人员的作用越来越重要。结论疾病分类人员应遵守疾病分类规则,加强编码知识的学习和不断提高编码技能,从而提高编码准确性,为医院争取合理的医保偿付。
Objective To explore the relationship between international disease classification and medical insurance payment. Methods By analyzing the role of single disease payment, DRGs payment, and international classification of diseases and surgical classification in the two payment methods, the relationship between the international classification of diseases and the payment of health insurance is analyzed. Results The international classification of diseases plays an important role in the payment of medical insurance according to the types of diseases. It is the basis and basis for the payment of single diseases and the DRGs. Whether the accuracy of coding influences the actual payment and the role of disease classification personnel becomes more and more important. Conclusion The disease classification staff should abide by the rules of disease classification, strengthen the learning of coding knowledge and continuously improve the coding skills, so as to improve the coding accuracy and strive for a reasonable reimbursement of medical insurance for hospitals.