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Call for consistent coding in diabetes mellitus using the Royal College of General Practitioners and NHS pragmatic classification of diabetes

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journal contribution
posted on 05.01.2016, 11:18 by S. de Lusignan, K. Sadek, H. McDonald, P. Horsfield, N. H. Sadek, A. Tahir, T. Desombre, Kamlesh Khunti
BACKGROUND: The prevalence of diabetes is increasing with growing levels of obesity and an aging population. New practical guidelines for diabetes provide an applicable classification. Inconsistent coding of diabetes hampers the use of computerised disease registers for quality improvement, and limits the monitoring of disease trends. OBJECTIVE: To develop a consensus set of codes that should be used when recording diabetes diagnostic data. METHODS: The consensus approach was hierarchical, with a preference for diagnostic/disorder codes, to define each type of diabetes and non-diabetic hyperglycaemia, which were listed as being completely, partially or not readily mapped to available codes. The practical classification divides diabetes into type 1 (T1DM), type 2 (T2DM), genetic, other, unclassified and non-diabetic fasting hyperglycaemia. We mapped the classification to Read version 2, Clinical Terms version 3 and SNOMED CT. RESULTS: T1DM and T2DM were completely mapped to appropriate codes. However, in other areas only partial mapping is possible. Genetics is a fastmoving field and there were considerable gaps in the available labels for genetic conditions; what the classification calls 'other' the coding system labels 'secondary' diabetes. The biggest gap was the lack of a code for diabetes where the type of diabetes was uncertain. Notwithstanding these limitations we were able to develop a consensus list. CONCLUSIONS: It is a challenge to develop codes that readily map to contemporary clinical concepts. However, clinicians should adopt the standard recommended codes; and audit the quality of their existing records.

History

Citation

Informatics in Primary Care (Now known as Journal of Innovation in Health Informatics), 2012, 20 (2), pp. 103-113

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Health Sciences

Version

VoR (Version of Record)

Published in

Informatics in Primary Care (Now known as Journal of Innovation in Health Informatics)

Publisher

BCS, The Chartered Institute for IT, Radcliffe Medical Press

issn

1476-0320

eissn

1475-9985

Acceptance date

01/05/2012

Available date

05/01/2016

Publisher version

http://hijournal.bcs.org/index.php/jhi/article/view/31

Language

en