Intest Res.  2011 Apr;9(1):1-11. 10.5217/ir.2011.9.1.1.

Clinical Classification of Colorectal Epithelial Tumors and Proposal for Diagnostic Coding

Affiliations
  • 1Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea. jokim31@hanafos.com
  • 2Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
  • 3Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Korea.
  • 4Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
  • 5Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.
  • 6Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
  • 7Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 8Department of Internal Medicine, Ewha Woman's University School of Medicine, Seoul, Korea.
  • 9Department of Internal Medicine, National Cancer Center, Goyang, Korea.
  • 10Department of Internal Medicine, Dankook University College of Medicine, Seoul, Korea.
  • 11Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea.
  • 12Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
  • 13Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 14Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
  • 15Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.

Abstract

The Korean Standard Classification of Diseases (KCD), which reflects the International Classification of Diseases (ICD), is a fundamental coding system for the diagnosis of colorectal epithelial tumors. The KCD coding of colorectal lesions is entirely up to the clinician and is based on pathologic reports. However, coding discrepancies have arisen among physicians using the KCD and pathologists using the ICD for Oncology-3 (ICD-O-3). The Korean Society of Pathologists recently proposed a standardized pathology-reporting format and guidelines for the coding of colorectal cancer to decrease these discrepancies among pathologists. However, ICD and ICD-O are simple classification codes based on pathologic reports, and are neither intended nor suitable for indexing of distinct clinical entities. For appropriate diagnostic coding using the KCD, a corrected coding principle based upon pathologic reports is required, and unified coding between KCD and ICD-O is necessary. A standardized pathologic report format and communication with understanding between physicians and pathologists should be established. Additionally, the private medical insurance system for colorectal cancer should be revised to reduce conflicts among patients, clinicians, and insurance companies over the medical coding system.

Keyword

Colorectal Epithelial Tumor; Coding System
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