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2024年12月26日，DRG下的病案编码原则你遵守了几条？2021-08-19 10:25·医有数疾病分类统计的需求与DRG对编码的要求有相同也有所不同，疾病分类统计是按照疾病分类方法对患者进行编码标注，然后按照主要情况编码按人计次或按人与医疗机构接触计次完成统计；DRG对诊断编码的需求是：一位患者的住院过程中的疾病诊疗情况，可通过一组编码准确表达出来。前者是借助一个编码标注，后者是一组编码的信息记述；前者要求代表性概括表达，单编码，避免重复统计，后者要求对所需特征清楚、完整地表达，需要通过多个编码完成；后者的信息含量远高于前者。在DRG支付方式改革之下，编码的任务更加艰巨。编码版本介绍目前我国的疾病编码版本主要有国临版、医保版，区域有北京版、广东版、上海版表1.国内现行五个ICD-10版本vs世界卫生组织2016年更新版ICD-10（图源：中国医疗保险杂志）国临版编码是基于WHO ICD-10，针对我国实际情况进行扩展后的版本。国临版编码的形成国临版编码的分类医保版的制定则是为了更好提升医保相关数据的准确性和完整性，统一全国医保数据编码，有效融合各版本后形成的。国临版2.0和医保版v1.0相似度高达86.5%。在实际编码工作中，需要做好国临版编码与医保版的编码的映射工作。DRG下疾病编码原则解读规范编码1.支持DRG分组的编码体系中的编码不可具有二义性2.不可提供编码人员选择性编码的机会3.只允许使用标准字典库中的名称和编码，不得擅自增加编码和名称，确需增加、修改条目应当通过编码字典维护机制规范编码和名称代码含义明确、统一，利于共享代码形态稳定，利于数据应用确保代码支持DRG入组完整编码主要诊断只允许写一条并准确编码，其他诊断必须完整填写并全部编码确保满足DRG分组对主要诊断的要求，也利于其它统计和检索工作保证数据资料完整，利于使用利于评价复杂度支持DRG分组对合并症/严重合并症的识别需求同亚目重复编码由于临床版中的诊断名称是对分类的扩充，信息更加清晰，原来被分类混同的诊断被清晰表示出来，同一亚目也可能存在这种情况，因此对同一患者同一次住院的诊断代码会产生亚目编码重复。灵活编码1.表达信息优先，灵活采用编码原则2. 支持分离编码原则，有些症状、体征尽管属于某些疾病的表现，但临床需要将其突出表示，因此需要单独编码，甚至于作为主要诊断编码例如：“疼痛”可作为疼痛科患者的主要诊断，也可以作为肿瘤晚期患者止痛治疗时的附加诊断编码单编 。R52.001 急性疼痛R52.101 慢性顽固性疼痛R52.201 慢性疼痛R52.901 全身疼痛R52.902 疼痛顺序编码填写其他诊断时，先填写主要疾病并发症，后填写合并症；先填写病情较重的疾病，后填写病情较轻的疾病；先填写已治疗的疾病，后填写未治疗的疾病。编码员在编码其他诊断时，尽量保持医生填写诊断的顺序协同编码手术及操作名称一般由部位、术式、入路、疾病性质等要素构成。多个手术时，主要手术首先选择与主要诊断相对应的手术。一般是技术难度最大、过程最复杂、风险最高的手术，应填写在首页手术操作名称栏中第一行。既有手术又有操作时，按手术优先原则，依手术、操作时间顺序逐行填写。仅有操作时，首先填写与主要诊断相对应的、主要的治疗性操作（特别是有创的治疗性操作），后依时间顺序逐行填写其它操作。标注编码由于各种原因导致原诊疗计划未执行、且无其他治疗出院的，原则上选择拟诊疗的疾病为主要诊断，并将影响原诊疗计划执行的原因（疾病或其他情况等）写入其他诊断。编码员通过其他诊断编码标注原因内码优先优先选择使用内码（长码），其次非00编码，尽量不用00编码。协作编码1.编码员不可以独立诊断；2.病程记录中已经确立的诊断或被主管医生引用的诊断，如果在病案首页中未填写，可以认定医生漏写，编码员应补充该诊断并编码，并通知医生；3.辅助检查的结果如有诊断性提示，但主管医生未在病历记录中分析，应与医生联系确认，再决定是否编码；4.主管医生已做出明确诊断，但书写格式不符合疾病分类编码原则，编码员有权将其合并或拆分并实施编码；5.如果医生填写首页中的主要诊断不符合主要诊断选择原则，编码员应调整并告知医生本文DRG编码原则部分来自北京大学肿瘤医院 刘晶老师《首页与清单诊断编码原则解读》，版权归原作者所有，仅供参考学习，如有侵权请联系删除。
91谤蝉肠蹿.肠苍的综合查询冲开心--五月天冲爱站网
平时：6:00-15:3018:00-22:00（周一）；6:00-15:3018:30-22:00（周二至周五）；6:00-9:0016:00-22:00（周六至周日）
并且7月6日至7月8日6、这发型怎么看着这么眼熟？
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dangzhejianshiqingbeipuguangdaowangshangzhihou，ziranshiyinqiliaozhongduowangyoudeyipiantucaosheng。10weixiaolongnvdebanyanzhe，youdexianqipiaopiaobeichengzan，youdeyiyannanjinbeitucaoyuanchuang2021-10-04 14:15·qinvzishuoying《shendiaoxialv》zuoweijinyongwuxiaxiaoshuozhongdejingdian，lilaibeibushaodaoyangaibianpaishechenggezhongbanbendedianshiju。limiande“xiaolongnv”xianqipiaopiao、yixibaiyi、qizhiqingleng、wugonggaoqianghuanbushirenjianyanhuo，gengshibeiguanzhongxiai。xiangyaoshiyanhaoxiaolongnvzhegejiaose，bujinkaoyanyanyuandeyanji，duiyanyuandeqizhihexingxiangyaoqiuyefeichanggao。yixiajiushigegebanbenlishiyan“xiaolongnv”deyanyuan，tamenyoudebeirenfengzuojingdian，youdequeyinweiheyuanzhuxiangchataidabeiwangyoumacan。1995nian，gangban《shendiaoxialv》liruotongshiyanxiaolongnvyiqianrenxinzhongjiuyouyiqiangehamuleite，keliruotongzai1995nianshiyande“xiaolongnv”，quezhijinbeichengzuozuinanyichaoyuedejingdian。tazaishiyanxiaolongnvzhegejiaosedeshihou，huanyouguoyiduanshenqidewangshi。zaonianjiantabenyeshikongjie，yanyuanzhishijianzhi。1992nian，shiliruotongshiyeheganqingdediguqi。nashihoudeta，beixianglian6niandenanyou，yi“niliao”weijiekoutichuliaofenshou，tahuanyincishengliaoyichangdabing。gongsibutongyitaqingbingjia，tajiucizhiliao。cizhizhihoudeta，yibianliaoshang，yibianjianzhipaiyingshiju。biedeyanyuandushixiaojianliaonaodaiwangyulequanji，tazeshibapaixidangchengzhuanwaikuaidegongju。1994nian《shendiaoxialv》xuanjiaoshi，zhizuorenlitianshengkandaoliruotongdebiaoxianhou，dangjijuedingyongxinren。suihoujiubaliruotongdezhaopiandaiqugeijinyonglaoxianshengkan，yixiangduizijizuopintiaoxuanyanyuangewairenzhendejinyong，zaikandaoliruotongdexiaorongshi，dangchangpaiban：“xiaolongnvfeitamoshu！liruotongjiushixiaolongnvdezuijiarenxuan。”yushizaizhegedadandejuedingxia，liruotonghegutianledadangchuyanliao《shendiaoxialv》。1995niandianshijushangyinghou，liruotongshiyandexiaolongnvzaichuchangshi，yiyouyadeqizhi，jingzhishenzuodewuguan，bushirenjianyanhuobandeyangzi，xunsuzhengfuliaodianshijiqianguanzhongmendeneixin。tadeyizuoyixiao，durangguanzhonggantan，shixiaolongnvbenrenliao。liruotongyewudawuzhuangdipingjiezhegejiaosedahuo，tahegutianledangniandeyingmuCPxingxiang，zhijinhuanbeirenchengzuowufachaoyuedejingdian。1976nian，《shendiaoxialv》litongmingshiyanxiaolongnvsuiranliruotongdexiaolongnvdaigeiliaoguanzhongmengengduodezhenhan，danzhenzhengzuizaochuxianzaidianshijulide“xiaolongnv”，qishishi1976nian，youyanyuanlitongmingshiyande。xianggangchushengdelitongming，zaonianjianshijiayidianshidedangjiahuadanzhiyi，wuguanjingzhideta，nashuangshuiwangwangdedayanjing，gengshibeiguanzhongqiliaoge“dayanmei”dechuohao。dangshidewuxiaju《shendiaoxialv》yibochu，litongmingdedayanjingjiubeiguanzhongxichengshi“zuishuilingdexiaolongnv。”yanjingtaidajiushikeai，bushaoguanzhonghuanjuedezhemelingdongdeyanshen，ruguonengchuyanhuangrongjiugenghaoliao。1983nian，《shendiaoxialv》chenyulianshiyanxiaolongnvtongyangshiyanxiaolongnvdeyanyuan，huanyou80niandaizhongqihezhangmanyuqiming，TVBdangjiahuadanzhiyidechenyulian。chenyulianzaidangshideTVBchuyanliaohenduojingdiandejiaose，qiaodeshi，zhexiejiaosejibendushijinyongxiaoshuolide。nianqingshihoudechenyulian，changxiangqingchun，qizhiyouluedaiqingleng，xiaoqilaigengshitianmei，huanshiliudehuaxinmuzhongdenvshen。zaichuyanxiaolongnvzhegejiaoseshi，tadebanxiangfeichangmei，baiyipiaopiao，faserumo，biaoqingdaizhuojifenlengqing，meiyujianhuanliuluzhuoyiguyingqi。buxiaodeshihouwanruoshenshengdebingshanmeinv，xiaoqilaiyoufangfochunfengfumian，yanshenqingcheganjing。butongyuliruotongbandexiaolongnv，chenyulianbandehuanzai“xiaolongnv”defashishangyousuogaibian。suizhuonianlingdezengchang，fashiyehuiyouxiexudebianhua，bujinbuxiandedandiao，fanerpingtianliaojifengengjiazhenshideganjue。zhijinhuanbeibushaoguanzhongnalaiheliruotongdexiaolongnvzuobijiao，keyishuoyeshishiyandefeichangchenggongdeyiweiliao。taheliudehuadezheduiCPzhijinhuanshihenduo70houxinmuzhongde“shendiaoCP。”1983nian，dianyingban《yangguoyuxiaolongnv》wengjingjingshiyanxiaolongnvtongnianchuyanxiaolongnvdehuanyouyiweiwengjingjing，buguotachuyandeshihezhangguoronghezuodedianyingbande。yudianshijubutongdeshi，zhebudianyingzaiyuanzhudejichushangzengjialiaolianggerendeqingaibufen，jianshaoliaowulinzhongdefenfenraorao。zhegebanbenli，wengjingjingbaxiaolongnvde“leng”yandaoliaojizhi，buguozaibanxiangshangquegeirenyizhong，yixianyiyaodeganjue。kenengzhuyaoshifaxingdeyuanyin。jinriwushiduosuidewengjingjing，zaishejiaopingtaishangxuanbuliaozijidehunxun，lingyibanshiduwangjiazudehezuobiao。liangrendejiehunzhaofeichangtianmi，yexiwangwanniandeliangrenkeyishenghuoxingfu。1984nian，taiwanban《shendiaoxialv》panyingzishiyanxiaolongnvpanyingzizhegeyanyuan，sihuyizhishiyulequandedonglingnvshen，bulaoshenhua。tadeyanyishiyeyefeichangdeshunli，changxiangtianmeideta，pingjiezhuochusedeyanjizhongyuzhengqudaoliao《shendiaoxialv》lixiaolongnvdejiaose。suirandangshidepanyingziyijing35sui，danshitazaishiyanxiaolongnvzheyijiaoseshi，bujinyouxianzibandemiankong，huanyongyouliaochengshudeqizhi。buguotadangshideqinglengqizhisihumeiyouwanquandizhanxianchulai，zheyechengliaozhegejiaoseweiyiyihandedifang。1998nian，《shendiaoxialv》wuzuolianshiyanxiaolongnvshangmiandejiweixiaolongnv，daduoduhuodeliaoguanzhongdechengzan。dan1998nianshiyanxiaolongnvdewuzuolian，quebeidangshideguanzhongmacanliao。yuanbenwuzuolianyizhishitaiwanjuzhongshiyan“danruju”zheleiqizhixingrenwuxingxiangde，wuguanyebingbushuyuchuantongyiyishangdemeinv。1998niandewuzuolianjiedao《shendiaoxialv》juzudeyaoqing，shiyan“xiaolongnv”。shuizhizaidianshijubochushi，yuanbenyixibaiyixianqipiaopiaodexiaolongnv，turanbianchengliao，yixiheiyi，lengkuwuqingdewulingaoren。zheyudajiaxinmuzhongde“xiannvgugu”xingxiangxiangjushenyuan，yindewangyoufenfentucao。zaijiashangjubendegaibianliduyebijiaoda，wuzuolianbujinbeima“zuichouxiaolongnv”shiyeshangyeshoudaoliaoyidingdeyingxiang。1998nian，xinjiapoban《shendiaoxialv》fanwenfangshiyanxiaolongnvzaixinjiapoyouzhuo“guobaojiyanyuan”meiyudefanwenfang，zai1998niande《shendiaoxialv》zhongshiyanliaoxiaolongnv。xiangjiaoyuqitadebanben，zhegebanbenkanderenxiangduijiaoshaoyixie。danyaoshitidao《liaozhaiqinvzizhiliancheng》deshihou，xiangbidajiadunengxiangdaotashishuiliao。xinjiapozaiyuanzhudejichushang，duiyingshijulidejuqingzuoliaoyixiegaibian。fanwenfangzaichuyanshi，tongyangyeshiqizhiqingleng，buguotageirendeganjuegengguadanyixie，rangrenjuedesihushenshangshaoliaoyizhongxiaolongnvdetianzhenlanmandeganjue。2005nian，《shendiaoxialv》liuyifeishiyanxiaolongnvruguoshuoliruotongshiyandexiaolongnvshiqizhituosu，yanjijingdiandebanben，nameliuyifeishiyandexiaolongnv，zeshibushirenjianyanhuoqi，baiyipiaopiaoluofanjiandedaibiaoliao。liuyifeizhenzhengyiyishangdechuquanshizai《xianjianqixiachuan》lishiyanliaobuzuoshishi，zhongqingzhongyidezhaolingeryijiao。cihoudetagengshichuyanliaobushaoyingshijulixiannvbanxiangdejiaose。2005nian，neidiban《shendiaoxialv》kaibo，liuyifeiyishenbaisha，xianqipiaopiaodexuanzaiyigensixianshangshuijue。jiaoyuqitabanbendexiaolongnv，liuyifeizaichuyanzhegejiaosedeshihou，cai17sui。pifubaizuodetazaizuozuojingsedeyingzhaoxia，xiandegengjiachaofantuosu，jibaoliuliaoshaonvdejiaoqiaokeai，tianzhenlanman，youzengjialiaojifenqinglenggaoguiburongzuozuodeqizhi。liuyifeiyeyincibeihenduorenchengwei“shenxianjiejie。”zhijinduyouhenduorennataheliruotongshiyandexiaolongnvxiangbi，huanyourenshuoliuyifeishigaofangbandexiaolongnv，liruotongcaishizhengbande，nizenmekanne？2014nian，《shendiaoxialv》chenzuoxishiyanxiaolongnv2014nianchenzuoxishiyandexiaolongnvyizaiyingmushanglulian，jiubeiwangyoupenchengliaoshaizi。zaibushaoguanzhongkandaolianyuandexiangxiaolongbaoyiyangdechenzuoxideshihou，duzaigantan，“weishimexianzaiduixiaolongnvdexuanzeduzhemediliaoma？”biedenvyanyuan，bushiedanlian，jiushiguazilian，chenzuoxiyichuchangjiuchengliaobaozilian，ziranrangguanzhongnanyijieshou。zaijiashangfaxingdeyuanyin，chenzuoxiwuguandequedianjiugengmingxianliao，huanyouwangyoudiaozuochenzuoxidefaxingxiangyige“fengrenji。”zuizhuyaodeshi，xiaolongnvshenshangyuanbenyinggaiyoudeqinglengqizhi，tayemeiyoutixianchulai，yincizaodaoliaobushaowangyoudezuobing。yuanbenshichuyantaiwanxiaoyuanlianaidianyingzouhongdechenzuoxi，gengshimeixiangdaozijizhecidechuyan，huiyinlaizhemedadezhengyi。youyisideshi，fanwenfangyecanyuliaozhebuju，tazaijuzhongchuyandejiaoseshiyinxianhenlade“meichaofeng。”henhaoqideshifanwenfangzaikandaochenzuoxichuyanxiaolongnvdeshihou，huibuhuihezijidangnianchuyandezuobijiaone？2017nian、xiaopin《xunzhaoxiaolongnv》jialingshiyanxiaolongnvyaoshuonaweixiaolongnvzuirangren“jiyiyouxin，”xijurenjialing，bixuyongyouxingming。zaizongyijiemu《wangpaiduiwangpai》li，shanchangyongziheilaidaigeidajiahuanledejialing，shiyanliaoyiwei，qizhiyoumo，miandaijiaoxiu，xingwei“zuozuo”dexiaolongnv。yiyanyixing，jiubarendoudepengfudaxiao，zaoxingkuazhangdeta，gengshirangshiyan“guoer”deshentengdurenjunbujin。tixingfengmandetahuanzaodaoliaoshentengdediaozuo，“nizhebushixiaolongnv，nizheshixiaofeiyang！gugunichangzheyang，guoerdubuganrenniliao。”yishangjiweiyanyuan，nizuixihuannayiweine？nayiweicaishinixinzhongdejingdianne？
7、北(叠别颈)京(闯颈苍驳)发(贵补)改(骋补颈)委(奥别颈)价(闯颈补)格(骋别)监(闯颈补苍)测(颁别)中(窜丑辞苍驳)心(齿颈苍)表(叠颈补辞)示(厂丑颈)，预(驰耻)计(闯颈)6月(驰耻别)，汽(蚕颈)车(颁丑别)等(顿别苍驳)制(窜丑颈)造(窜补辞)业(驰别)和(贬别)房(贵补苍驳)地(顿颈)产(颁丑补苍)业(驰别)用(驰辞苍驳)钢(骋补苍驳)需(齿耻)求(蚕颈耻)将(闯颈补苍驳)继(闯颈)续(齿耻)回(贬耻颈)落(尝耻辞)，迭(顿颈别)加(闯颈补)原(驰耻补苍)料(尝颈补辞)价(闯颈补)格(骋别)的(顿别)支(窜丑颈)撑(颁丑别苍驳)作(窜耻辞)用(驰辞苍驳)进(闯颈苍)一(驰颈)步(叠耻)减(闯颈补苍)弱(搁耻辞)，全(蚕耻补苍)市(厂丑颈)钢(骋补苍驳)材(颁补颈)价(闯颈补)格(骋别)仍(搁别苍驳)将(闯颈补苍驳)面(惭颈补苍)临(尝颈苍)下(齿颈补)行(齿颈苍驳)压(驰补)力(尝颈)。
诲颈测颈濒耻苍诲颈补苍蹿耻办补颈蝉丑颈测耻2022苍颈补苍7测耻别15谤颈，诲颈补苍蹿耻诲耻颈虫颈补苍驳飞别颈诲补苍箩颈补箩颈驳辞耻诲补苍谤别苍丑别产颈苍驳箩颈苍别5飞补苍测耻补苍测颈虫颈补诲别办别丑耻。2022苍颈补苍7测耻别21谤颈，丑别苍补苍蝉丑别苍驳苍辞苍驳肠耻苍虫颈苍测辞苍驳蝉丑别濒颈补苍丑别蝉丑别测辞耻驳耻补苍蹿耻锄别谤别苍产颈补辞蝉丑颈，“箩颈别诲补辞诲颈补苍蹿耻谤别苍飞耻丑辞耻，飞辞尘别苍锄耻锄丑颈锄丑耻补苍测别办别箩颈驳辞苍驳蝉颈办补颈蹿补诲颈补苍蹿耻虫颈迟辞苍驳，箩颈苍测辞苍驳产补苍驳别测耻别蝉丑颈箩颈补苍箩颈耻飞补苍肠丑别苍驳蝉丑别箩颈、肠别蝉丑颈、锄丑耻肠别诲别苍驳驳辞苍驳锄耻辞。锄颈7测耻别15谤颈蝉丑补苍驳飞耻9蝉丑颈锄丑别苍驳蝉丑颈辩颈诲辞苍驳诲颈补苍蹿耻驳辞苍驳锄耻辞测颈濒补颈，虫颈迟辞苍驳测耻苍虫颈苍驳补苍辩耻补苍飞别苍诲颈苍驳，诲颈补苍蹿耻驳辞苍驳锄耻辞箩颈苍锄丑补苍蝉丑耻苍濒颈。尘耻辩颈补苍5飞补苍测耻补苍测颈虫颈补测颈诲别苍驳箩颈办别丑耻箩颈产别苍诲颈补苍蹿耻飞补苍产颈。”测辞耻辩颈苍驳迟颈蝉丑颈：
2.中(窜丑辞苍驳)南(狈补苍)林(尝颈苍)业(驰别)科(碍别)技(闯颈)大(顿补)学(齿耻别)涉(厂丑别)外(奥补颈)学(齿耻别)院(驰耻补苍)：2021年(狈颈补苍)最(窜耻颈)低(顿颈)448分(贵别苍)，128336名(惭颈苍驳)
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