DocDx

Handleiding voor het documenteren diagnose in PER-PD 301

International Classification of Diseases (ICD) is developed by WHO as worldwide health standard used to compare morbidity and mortality rates among its members to prepare for health planning. Currently, Ministry of Health adopted ICD 10 Version 2010 in order to assist in data analysis. Accuracy on ICD 10 coding depends on few variables including completeness of diagnosis documented by medical officers in the right column of Hospital Admission and Discharge Form (PER-PD 301). Manual for Documenting Diagnosis in PER-PD 301 is a guideline produced to improve quality of documented diagnosis. This Manual is been used since 2012 for training purposes. It contains the examples of in-patient morbidity and mortality diagnosis according to the ICD 10 needs.