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ICD-10-AM, ACHI, ACS
National Overview
ICD-10-AM, ACHI, ACS Development
ICD-10-AM Upgrade
The previous ICD-10-AM classification provider National Centre for Classification in Health (NCCH) was responsible for producing and updating a number of classification products in Australia under contract to The Australian Department of Health and Ageing (DoHA). The current provider is the National Casemix and Classification Centre (http://nccc.uow.edu.au/index.html).The following products are used in New Zealand:
- ICD-10-AM - The International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification consists of a tabular list of diseases and an accompanying alphabetic index.
- ACHI - Australian Classification of Health Interventions consists of a tabular list of interventions and accompanying alphabetic index.
- ACS – The Australian Coding Standards is a list of standards used in conjunction with ICD-10-AM and ACHI to optimise accurate and consistent application of the classification in clinical coding practice.
New Zealand upgraded to ICD-10-AM 6th edition at the same time as Australia on 1 July 2008.
The following table shows version implementation dates of ICD-10-AM/ACHI/ACS in New Zealand, including the proposed (but not yet confirmed) 2013 upgrade to 8th edition:
| Date of Implementation | ICD-10-AM/ACHI/ACS Version Upgrade |
| 01/07/1999 | 1st Edition |
| 01/07/2001 | 2nd Edition |
| 01/07/2004 | 3rd Edition |
| 01/07/2008 | 6th Edition |
| 01/07/2013 (Proposed) | 8th Edition (Proposed) |
If you require further information about the development, use and implementation of ICD-10-AM/ACHI/ACS in New Zealand please email: coding_helpdesk@moh.govt.nz
New Zealand Conventions
Morbidity data is collected in New Zealand using The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), The Australian Classification of Health Interventions (ACHI) and The Australian Coding Standards (ACS). The rules and conventions of ICD-10-AM/ACHI/ACS govern clinical coding practice and underpin consistency and accuracy of clinical coded information submitted to the National Collection – National Minimum Data Set (NMDS).
A New Zealand Convention is an additional requirement that clinical coders are required to follow. The conventions are developed and defined by the Ministry of Health in collaboration with relevant stakeholder groups.
| Australian Coding Standard (ACS) | New Zealand Convention (NZC) |
| Reporting Total Intensive Care Unit (ICU) Hours to the National Minimum Data Set (NMDS) Updated April 2011 | In New Zealand there is a requirement to capture Total Intensive Care Unit (ICU) Hours for events with an event end date on or after 1 July 2008. Total hours are to be reported for duration of stay in an Intensive Care Unit (ICU) during an episode of care. Refer to the NMDS Data Dictionary v7.1 for collection method: www.moh.govt.nz/moh.nsf/indexmh/dataandstatistics-technical-nmds |
| ACS 0029 Coding of Contracted Procedures Updated April 2011 | This standard relates to hospital treatment being carried out under contracting or subcontracting arrangements between two hospitals. The standard states ‘all procedures carried out under the contract are to be recorded and coded in both hospitals. The hospital not carrying out the procedure should flag the appropriate code’. However, the standard does say clinical coders should be familiar with their respective state/territory methods of reporting contracting information. In New Zealand only one hospital is to record and code the treatment provided under the contract arrangement and report to the National Minimum Data Set (NMDS). Where the hospital is a private hospital, it is preferred that the public hospital reports the event. However, the contract arrangement should specify the hospital that will be responsible for reporting the event to the NMDS. Contracted events must be reported to the NMDS with the appropriate agency, facility code and meet the 21 day reporting requirement. Refer to the New Zealand Casemix Framework for Publicly Funded Hospitals, WIESNZ10 Methodology 2010/11 v8, 5.2.39 Designated Hospital for Casemix Revenue on the following link: www.nzhis.govt.nz/moh.nsf/pagesns/300 |
| ACS 0032 Allied Health Intervention | There is no mandatory requirement in New Zealand to report allied health interventions to the National Minimum Data Set (NMDS). Reporting allied health interventions to the NMDS is optional. |
| ACS 0048 Condition Onset Flag Updated: October 2009 | New Zealand did not adopt ACS 0048 Condition Onset Flag as part of the 1 July 2008 ICD-10-AM 6th edition upgrade. |
| ACS 0233 Morphology | Reporting morphology to the National Minimum Data Set (NMDS) is not a mandatory requirement in New Zealand. Morphology information is collected directly by the New Zealand Cancer Registry. Reporting morphology to the NMDS is optional. |
| ACS 0503 Drug, Alcohol and Tobacco Use Disorders Updated April 2011. | Z71.6 Counselling for tobacco use disorder This New Zealand convention is related to the mandatory reporting requirements aligned to the 2009 Health Target ‘Better help for smokers to quit’. Z71.6 Counselling for tobacco use disorder is assigned as an additional diagnosis when there is evidence within the clinical record of one or more of the following: 1. Brief advice to quit including documentation where advice and/or treatment has been offered but declined by patient. 2. Charting or prescribing of the following pharmacotherapies when used for smoking cessation and/or temporary abstinence purposes for public hospital inpatients.
3. A referral made to a smoking cessation specialist or programme (inpatient or outpatient). This may include any of the following:
4. A referral to General Practitioner or Practice Nurse for follow-up of smoking or tobacco dependence, or smoking cessation, post-discharge from hospital. Clinical coders are advised to:
‘ABC for Smoking Cessation’ by Dr Hayden McRobbie - (Duration: 26:41 minutes) Click play to view the video New: updated April 2011 Z58.7 Exposure to tobacco smoke Assign the code Z58.7 Exposure to tobacco smoke when:
Exclusions: Z58.7 Exposure to tobacco smoke is not assigned when: 1. The patient has been exposed to tobacco smoke as a one off or incidental encounter which may have exacerbated a chronic condition and/or precipitated an admission to hospital for any other conditions. 2. When a neonate (0-28 completed days) is born with or is subsequently admitted to hospital with any documented condition specifically attributed to maternal use of tobacco the code P04.2 Fetus and newborn affected by maternal use of tobacco is assigned according to the guidelines in the Australian Coding Standard (ACS) 1609 Newborns affected by maternal causes and birth trauma. Clinical coders are advised to:
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| ACS 1006 Ventilatory Support Updated April 2011 Reporting Total Hours of Noninvasive Ventilation (NIV) and Continuous Ventilatory Support (CVS) to the National Minimum Data Set (NMDS) | In New Zealand there is a requirement to capture Total Hours of NIV and CVS. Report Total Hours of NIV and/or CVS during an episode of care for all patients according to the guidelines in the NMDS Data Dictionary v7.1 and ACS 1006 Ventilatory Support. NMDS Data Dictionary link www.moh.govt.nz/moh.nsf/indexmh/dataandstatistics-technical-nmds |
| ACS 1505 Single Spontaneous Vaginal Delivery | In New Zealand the intervention code 90467-00 [1336] Spontaneous vertex delivery must be assigned for all cases of normal vaginal delivery. |
| ACS 1904 Procedural Complications Effective 1 October 2009 | This convention is an amendment to ACS 1904 Procedural Complications with regard to the code selection of principal diagnosis for ‘misadventure’ and ‘postprocedural complications’. Misadventure: The diagnosis codes for conditions classified as ‘misadventures’ are found in the ICD-10-AM code range of T80-T88 Complications of surgical and medical care, not elsewhere classified. Postprocedural Complications: The diagnosis codes for conditions classified as ‘postprocedural complications’ are found in the ICD-10-AM code range of T80-T88 in the postprocedural disorder categories at the end of each chapter. For further information, please refer to the Procedural Complications flowchart (Excel, 37 KB) |
| ACS 2001 External cause code use and sequencing ACS 0026 Admission for clinical trial, drug challenge or therapeutic drug monitoring | Z03.6 Observation for suspected toxic effect from ingested substance requires the assignment of an external cause code to identify the specific substance. This is a mandatory requirement in New Zealand as specified in the NMDS Data Dictionary. |
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