1. Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011 Република Србија МИНИСТАРСТВО ЗДРАВЉА Linda Best 10.45 - 11.30 Tuesday, 6th December 2011 ACHI development and principles

2. Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011 Република Србија МИНИСТАРСТВО ЗДРАВЉА Australian Classification of Health Interventions – ACHI  WHO ICD-10 does not have a companion intervention classification  An Australian intervention classification was produced to be used in conjunction with ICD-10- AM (Australian modification)  Self-contained classification based on a fee schedule (MBS)

3. Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011 Република Србија МИНИСТАРСТВО ЗДРАВЉА Australian Classification of Health Interventions – ACHI cont.  Contains codes for surgical operations, medical procedures, allied health and dental interventions  Codes are numeric only – five digits with a two digit extension

4. Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011 Република Србија МИНИСТАРСТВО ЗДРАВЉА Structure of ACHI  Numbering system and blocks - Code numbers not in numerical order - Block numbers are used to aggregate codes - Blocks in numerical order, to help find codes

5. Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011 Република Србија МИНИСТАРСТВО ЗДРАВЉА Structure of ACHI cont.  Multi-axial structure, three axes: - Primary axis – site - Secondary axis – procedure type - Tertiary axis – specific site, procedure or technique used

6. Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011 Република Србија МИНИСТАРСТВО ЗДРАВЉА Structure of ACHI cont.  For example: Eardrum and middle ear Examination 41629-00Exploration of middle ear 41650-00Inspection of tympanic membrane, unilateral Application, insertion, removal 41647-00Ear toilette, unilateral Incision 41626-00Myringotomy, unilateral 41632-00Myringotomy with insertion of tube, unilateral Type of procedure

7. Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011 Република Србија МИНИСТАРСТВО ЗДРАВЉА Structure of ACHI cont. 42773-00 Repair of retinal detachment by diathermy 42773-01 Repair of retinal detachment by cryotherapy The first five characters represent the MBS item number: 42773 Detached retina, diathermy or cryotherapy for The last two characters are allocated for each new procedural concept derived from the MBS item description

8. Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011 Република Србија МИНИСТАРСТВО ЗДРАВЉА Structure of ACHI cont.  Exceptions: - Dental - Obstetrics - Radiation oncology - Imaging and miscellaneous procedures

9. Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011 Република Србија МИНИСТАРСТВО ЗДРАВЉА Coding procedures with ACHI  Conventions used in Tabular List of Interventions –  ACS 0040 - Same as those for diseases  essential and nonessential modifiers  NEC – not elsewhere classified  ‘see’ and ‘see also’

10. Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011 Република Србија МИНИСТАРСТВО ЗДРАВЉА Coding procedures with ACHI cont.  Conventions used in Tabular List of Interventions –  ACS 0040 (cont) - New or different:  includes notes – refers to procedural components or equipment used that is inherent in the description of a code or block heading or may further define the site  and/or in code titles – ‘and’ means and, ‘or’ means or. 59903-00 [607]Left ventriculography 59903-01 [607]Right ventriculography 59903-02 [607]Left and right ventriculography

11. Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011 Република Србија МИНИСТАРСТВО ЗДРАВЉА Coding procedures with ACHI cont.  Conventions used in Tabular List of Interventions –  ACS 0040 (cont) - ‘Omit code’ – instruction in index next to procedures that are an operative approach, e.g. laparotomy for resection of bowel. - ‘see block’ – instruction that you must go to the Tabular List and look at the codes in the block

12. Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, 05-09.12.2011 Република Србија МИНИСТАРСТВО ЗДРАВЉА Process for procedure coding  Three basic steps: 1.Analyse the documentation used in the record to describe the procedure – main term and modifiers 2.Locate the main term in the Alphabetic Index, then check the indented modifiers 3.Verify the code shown in the index by checking it in the Tabular List