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Episode of care—principal diagnosis, code (ICD-10-AM 7th edn) ANN{.N[N]}

Identifying and definitional attributes

Metadata item type:Help on this termData Element
Short name:Help on this termPrincipal diagnosis—episode of care
METEOR identifier:Help on this term391326
Registration status:Help on this term
  • Commonwealth Department of Health, Recorded 16/07/2015
  • Health, Superseded 02/05/2013
  • National Health Performance Authority (retired), Retired 01/07/2016
Definition:Help on this termThe diagnosis established after study to be chiefly responsible for occasioning an episode of admitted patient care, an episode of residential care or an attendance at the health care establishment, as represented by a code.
Data Element Concept:Episode of care—principal diagnosis

Value domain attributes

Representational attributes

Classification scheme:International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification 7th edition
Representation class:Help on this termCode
Data type:Help on this termString
Format:Help on this termANN{.N[N]}
Maximum character length:Help on this term6

Data element attributes

Collection and usage attributes

Guide for use:Help on this term

The principal diagnosis must be determined in accordance with the Australian Coding Standards. Each episode of admitted patient care must have a principal diagnosis and may have additional diagnoses. The diagnosis can include a disease, condition, injury, poisoning, sign, symptom, abnormal finding, complaint, or other factor influencing health status.

As a minimum requirement the Principal diagnosis code must be a valid code from the current edition of ICD-10-AM.

For episodes of admitted patient care, some diagnosis codes are too imprecise or inappropriate to be acceptable as a principal diagnosis and will group to an error DRG in the Australian Refined Diagnosis Related Groups.

Diagnosis codes starting with a V, W, X or Y, describing the circumstances that cause an injury, rather than the nature of the injury, cannot be used as principal diagnosis. Diagnosis codes which are morphology codes cannot be used as principal diagnosis.

Collection methods:Help on this term

A principal diagnosis should be recorded and coded upon separation, for each episode of admitted patient care or episode of residential care or attendance at a health care establishment. The principal diagnosis is derived from and must be substantiated by clinical documentation.

Comments:Help on this termThe principal diagnosis is one of the most valuable health data elements. It is used for epidemiological research, casemix studies and planning purposes.

Source and reference attributes

Origin:Help on this term

National Centre for Classification in Health

National Data Standard for Injury Surveillance Advisory Group

Relational attributes

Related metadata references:Help on this term
Is used in the formation of Episode of admitted patient care—diagnosis related group, code (AR-DRG v 6) ANNA
  • Commonwealth Department of Health, Recorded 16/07/2015
  • Health, Standard 30/06/2013
  • Tasmanian Health, Incomplete 23/07/2012
Is used in the formation of Episode of admitted patient care—diagnosis related group, code (AR-DRG v 6.0x) ANNA
  • Tasmanian Health, Superseded 06/09/2016
Is used in the formation of Episode of admitted patient care—diagnosis related group, code (AR-DRG v 7.0) ANNA
  • Tasmanian Health, Standard 06/09/2016
Is used in the formation of Episode of admitted patient care—major diagnostic category, code (AR-DRG v 6) NN
  • Commonwealth Department of Health, Recorded 16/07/2015
  • Health, Standard 30/06/2013
  • Tasmanian Health, Superseded 07/09/2016
Is used in the formation of Episode of admitted patient care—major diagnostic category, code (AR-DRG v 8.0) NN
  • Tasmanian Health, Superseded 12/01/2018
Supersedes Episode of care—principal diagnosis, code (ICD-10-AM 6th edn) ANN{.N[N]}
  • Health, Superseded 22/12/2009
Has been superseded by Episode of care—principal diagnosis, code (ICD-10-AM 8th edn) ANN{.N[N]}
  • Health, Superseded 13/11/2014
  • National Health Performance Authority (retired), Not progressed 01/07/2016
  • Tasmanian Health, Standard 02/09/2016
Implementation in Data Set Specifications:Help on this term
All attributes +

Acute coronary syndrome (clinical) DSSHealth, Superseded 02/05/2013

Admitted patient care NMDS 2010-11Health, Superseded 18/01/2011

DSS specific attributes +

Implementation start date: 01/07/2010

Implementation end date: 30/06/2011

DSS specific information:

The principal diagnosis is a major determinant in the classification of Australian Refined Diagnosis Related Groups and Major Diagnostic Categories.

Where the principal diagnosis is recorded prior to discharge (as in the annual census of public psychiatric hospital patients), it is the current provisional principal diagnosis. Only use the admission diagnosis when no other diagnostic information is available. The current provisional diagnosis may be the same as the admission diagnosis.


Admitted patient care NMDS 2011-12Commonwealth Department of Health, Recorded 16/07/2015
Health, Superseded 11/04/2012

DSS specific attributes +

Implementation start date: 01/07/2011

Implementation end date: 30/06/2012

DSS specific information:

The principal diagnosis is a major determinant in the classification of Australian Refined Diagnosis Related Groups and Major Diagnostic Categories.

Where the principal diagnosis is recorded prior to discharge (as in the annual census of public psychiatric hospital patients), it is the current provisional principal diagnosis. Only use the admission diagnosis when no other diagnostic information is available. The current provisional diagnosis may be the same as the admission diagnosis.


Admitted patient care NMDS 2012-13Health, Superseded 02/05/2013

DSS specific attributes +

Implementation start date: 01/07/2012

Implementation end date: 30/06/2013

DSS specific information:

The principal diagnosis is a major determinant in the classification of Australian Refined Diagnosis Related Groups and Major Diagnostic Categories.

Where the principal diagnosis is recorded prior to discharge (as in the annual census of public psychiatric hospital patients), it is the current provisional principal diagnosis. Only use the admission diagnosis when no other diagnostic information is available. The current provisional diagnosis may be the same as the admission diagnosis.


Admitted patient mental health care NMDS 2010-11Health, Superseded 18/01/2011

DSS specific attributes +

Implementation start date: 01/07/2010

Implementation end date: 30/06/2011

DSS specific information:

Effective for collection from 01/07/2006

Admitted patient mental health care NMDS 2011-12Health, Superseded 07/12/2011

DSS specific attributes +

Implementation start date: 01/07/2011

Implementation end date: 30/06/2012

DSS specific information:

Effective for collection from 01/07/2006

Admitted patient mental health care NMDS 2012-13Health, Superseded 02/05/2013

DSS specific attributes +

Implementation start date: 01/07/2012

Implementation end date: 30/06/2013

DSS specific information:

Effective for collection from 01/07/2006

Admitted patient palliative care NMDS 2010-11Health, Superseded 21/12/2010

DSS specific attributes +

Implementation start date: 01/07/2010

Implementation end date: 30/06/2011


Admitted patient palliative care NMDS 2011-12Health, Superseded 07/03/2012

DSS specific attributes +

Implementation start date: 01/07/2011

Implementation end date: 30/06/2012


Admitted patient palliative care NMDS 2012-13Health, Superseded 02/05/2013

DSS specific attributes +

Implementation start date: 01/07/2012

Implementation end date: 30/06/2013


Community mental health care NMDS 2010-11Health, Superseded 01/12/2010

DSS specific attributes +

Implementation start date: 01/07/2010

Implementation end date: 30/06/2011

DSS specific information:

Codes can be used from ICD-10-AM or from The ICD-10-AM Mental Health Manual: An Integrated Classification and Diagnostic Tool for Community-Based Mental Health Services, published by the National Centre for Classification in Health.


Community mental health care NMDS 2011-12Health, Superseded 07/03/2012

DSS specific attributes +

Implementation start date: 01/07/2011

Implementation end date: 30/06/2012

DSS specific information:

Codes can be used from ICD-10-AM or from The ICD-10-AM Mental Health Manual: An Integrated Classification and Diagnostic Tool for Community-Based Mental Health Services, published by the National Centre for Classification in Health.


Community mental health care NMDS 2012-13Health, Superseded 07/02/2013

DSS specific attributes +

Implementation start date: 01/07/2012

Implementation end date: 30/06/2013

DSS specific information:

Codes can be used from ICD-10-AM or from The ICD-10-AM Mental Health Manual: An Integrated Classification and Diagnostic Tool for Community-Based Mental Health Services, published by the National Centre for Classification in Health.


Residential mental health care NMDS 2010-11Health, Superseded 21/12/2010

DSS specific attributes +

Implementation start date: 01/07/2010

Implementation end date: 30/06/2011

DSS specific information:

Codes can be used from ICD-10-AM or from The ICD-10-AM Mental Health Manual: An Integrated Classification and Diagnostic Tool for Community-Based Mental Health Services, published by the National Centre for Classification in Health 2002.

The principal diagnosis should be recorded and coded upon the end of an episode of residential care (i.e. annually for continuing residential care).


Residential mental health care NMDS 2011-12Health, Superseded 07/03/2012

DSS specific attributes +

Implementation start date: 01/07/2011

Implementation end date: 30/06/2012

DSS specific information:

Codes can be used from ICD-10-AM or from The ICD-10-AM Mental Health Manual: An Integrated Classification and Diagnostic Tool for Community-Based Mental Health Services, published by the National Centre for Classification in Health 2002.

The principal diagnosis should be recorded and coded upon the end of an episode of residential care (i.e. annually for continuing residential care).


Residential mental health care NMDS 2012-13Health, Superseded 06/09/2013

DSS specific attributes +

Implementation start date: 01/07/2012

Implementation end date: 30/06/2013

DSS specific information:

Codes can be used from ICD-10-AM or from The ICD-10-AM Mental Health Manual: An Integrated Classification and Diagnostic Tool for Community-Based Mental Health Services, published by the National Centre for Classification in Health 2002.

The principal diagnosis should be recorded and coded upon the end of an episode of residential care (i.e. annually for continuing residential care).


Implementation in Indicators:Help on this term
Used as Numerator

3.3 Estimated annual number of lumbar spine surgery admissions to hospital per 100,000 people aged 18 years and over, 2010-11 to 2012-13 National Health Performance Authority (retired), Retired 01/07/2016
Australian Commission on Safety and Quality in Health Care, Standard 23/11/2016

3.5 Number of hysterectomy and endometrial ablation admissions to hospital per 100,000 women, 2012-13 National Health Performance Authority (retired), Retired 01/07/2016
Australian Commission on Safety and Quality in Health Care, Standard 23/11/2016

3.8 Number of hip fracture admissions to hospital per 100,000 people aged 65 years and over, 2012–13 National Health Performance Authority (retired), Retired 01/07/2016
Australian Commission on Safety and Quality in Health Care, Standard 23/11/2016

3.9 Average length of stay for hip fracture patients aged 65 years and over, major and large public hospitals, 2012–13 National Health Performance Authority (retired), Retired 01/07/2016
Australian Commission on Safety and Quality in Health Care, Standard 23/11/2016

6.4 Estimated annual number of asthma and related respiratory admissions to hospital per 100,000 people aged 3 to 19 years, 2010-11 to 2012-13 National Health Performance Authority (retired), Retired 01/07/2016
Australian Commission on Safety and Quality in Health Care, Standard 23/11/2016

6.5 Estimated annual number of asthma admissions to hospital per 100,000 people aged 20 to 44 years, 2010-11 to 2012-13 National Health Performance Authority (retired), Retired 01/07/2016
Australian Commission on Safety and Quality in Health Care, Standard 23/11/2016

6.6 Number of asthma and COPD admissions to hospital per 100,000 people aged 45 years and over, 2012–13 National Health Performance Authority (retired), Retired 01/07/2016
Australian Commission on Safety and Quality in Health Care, Standard 23/11/2016

6.7 Number of heart failure admissions to hospital per 100,000 people aged 40 years and over, 2012–13 National Health Performance Authority (retired), Retired 01/07/2016
Australian Commission on Safety and Quality in Health Care, Standard 23/11/2016

6.8 Number of diabetes-related lower limb amputation admissions to hospital per 100,000 people aged 18 years and over, 2012–13 National Health Performance Authority (retired), Retired 01/07/2016
Australian Commission on Safety and Quality in Health Care, Standard 23/11/2016

6.9 Average length of stay for stroke patients aged 65 years and over, major and large public hospitals, 2012–13 National Health Performance Authority (retired), Retired 01/07/2016
Australian Commission on Safety and Quality in Health Care, Standard 23/11/2016

Australian Atlas of Healthcare Variation: Number of cervical loop excision or cervical loop ablation hospitalisations per 100,000 women, aged 15 years and over, 2012-13 to 2014-15Australian Commission on Safety and Quality in Health Care, Standard 07/06/2017

Australian Atlas of Healthcare Variation: Number of endometrial ablation hospitalisations per 100,000 women, aged 15 years and over, 2012-13 to 2014-15Australian Commission on Safety and Quality in Health Care, Standard 07/06/2017

Australian Atlas of Healthcare Variation: Number of lumbar spinal decompression (excluding lumbar spinal fusion) hospitalisations per 100,000 people aged 18 years and over, 2012-13 to 2014-15Australian Commission on Safety and Quality in Health Care, Standard 07/06/2017

Australian Atlas of Healthcare Variation: Number of lumbar spinal fusion (excluding lumbar spinal decompression) hospitalisations per 100,000 people, aged 18 years and over, 2012-13 to 2014-15Australian Commission on Safety and Quality in Health Care, Standard 07/06/2017

Australian Atlas of Healthcare Variation: Number of lumbar spinal fusion hospitalisations per 100,000 people, aged 18 years and over, 2012-13 to 2014-15Australian Commission on Safety and Quality in Health Care, Standard 07/06/2017

National Health Performance Authority, Healthy Communities: Number of selected potentially avoidable hospitalisations per 100,000 people, 2011–12 National Health Performance Authority (retired), Retired 01/07/2016

National Health Performance Authority, Hospital Performance: Median waiting time for surgery for malignant cancer, 2011-12 National Health Performance Authority (retired), Superseded 02/10/2014

National Health Performance Authority, Hospital Performance: Median waiting time for surgery for malignant cancer, 2012-13 National Health Performance Authority (retired), Retired 01/07/2016

National Health Performance Authority, Hospital Performance: Number of surgeries for malignant cancer, 2011-12 National Health Performance Authority (retired), Superseded 02/10/2014

National Health Performance Authority, Hospital Performance: Number of surgeries for malignant cancer, 2012-13 National Health Performance Authority (retired), Retired 01/07/2016

National Health Performance Authority, Hospital Performance: Percentage of people who received surgery for malignant cancer within 30 days, 2011-12 National Health Performance Authority (retired), Superseded 02/10/2014

National Health Performance Authority, Hospital Performance: Percentage of people who received surgery for malignant cancer within 30 days, 2012-13 National Health Performance Authority (retired), Retired 01/07/2016

National Health Performance Authority, Hospital Performance: Percentage of people who received surgery for malignant cancer within 45 days, 2011-12 National Health Performance Authority (retired), Superseded 02/10/2014

National Health Performance Authority, Hospital Performance: Percentage of people who received surgery for malignant cancer within 45 days, 2012-13 National Health Performance Authority (retired), Retired 01/07/2016

National Health Performance Authority, Hospital Performance: Percentage of people who waited longer than the clinical urgency category time for surgery for malignant cancer, 2011-12 National Health Performance Authority (retired), Retired 01/07/2016

National Healthcare Agreement: P04-Incidence of selected cancers, 2010Health, Superseded 08/06/2011

National Healthcare Agreement: P62-Hospitalisation for injury and poisoning, 2010Health, Superseded 08/06/2011

National Healthcare Agreement: PB f-By 2014-15, improve the provision of primary care and reduce the proportion of potentially preventable hospital admissions by 7.6 per cent over the 2006-07 baseline to 8.5 per cent of total hospital admissions, 2013Health, Superseded 30/04/2014

National Healthcare Agreement: PB f-By 2014-15, improve the provision of primary care and reduce the proportion of potentially preventable hospital admissions by 7.6 per cent over the 2006-07 baseline to 8.5 per cent of total hospital admissions, 2014Health, Superseded 14/01/2015

National Healthcare Agreement: PB f-By 2014-15, improve the provision of primary care and reduce the proportion of potentially preventable hospital admissions by 7.6 per cent over the 2006-07 baseline to 8.5 per cent of total hospital admissions, 2015Health, Superseded 08/07/2016

National Healthcare Agreement: PI 09-Incidence of heart attacks (acute coronary events), 2015Health, Superseded 08/07/2016

National Healthcare Agreement: PI 09-Incidence of heart attacks, 2013Health, Superseded 30/04/2014

National Healthcare Agreement: PI 09-Incidence of heart attacks, 2014Health, Superseded 14/01/2015

National Healthcare Agreement: PI 18-Selected potentially preventable hospitalisations, 2013Health, Superseded 30/04/2014

National Healthcare Agreement: PI 18-Selected potentially preventable hospitalisations, 2014Health, Superseded 14/01/2015

National Healthcare Agreement: PI 18-Selected potentially preventable hospitalisations, 2015Health, Superseded 08/07/2016

National Healthcare Agreement: PI 23-Unplanned hospital readmission rates, 2013Health, Superseded 30/04/2014

National Healthcare Agreement: PI 23-Unplanned hospital readmission rates, 2014Health, Superseded 14/01/2015

National Healthcare Agreement: PI 23-Unplanned hospital readmission rates, 2015Health, Superseded 08/07/2016

National Healthcare Agreement: PI 27-Number of hospital patient days used by those eligible and waiting for residential aged care, 2013Health, Superseded 30/04/2014

National Healthcare Agreement: PI 27-Number of hospital patient days used by those eligible and waiting for residential aged care, 2014Health, Superseded 14/01/2015

National Healthcare Agreement: PI 27-Number of hospital patient days used by those eligible and waiting for residential aged care, 2015Health, Superseded 08/07/2016

National Indigenous Reform Agreement: P11-Child under 5 hospitalisation rates by principal diagnosis, 2010Community Services (retired), Superseded 04/04/2011

Number of lumbar spinal decompression (excluding lumbar spinal fusion) hospitalisations per 100,000 people aged 18 years and over, 2012-13 to 2014-15 and 2015-16 to 2017-18Australian Commission on Safety and Quality in Health Care, Standard 27/04/2021

Number of lumbar spinal fusion (excluding lumbar spinal decompression) hospitalisations per 100,000 people, aged 18 years and over, 2012-13 to 2014-15 and 2015-16 to 2017-18Australian Commission on Safety and Quality in Health Care, Standard 27/04/2021

Number of lumbar spinal fusion (with or without lumbar spinal decompression) hospitalisations per 100,000 people, aged 18 years and over, 2012-13 to 2014-15 and 2015-16 to 2017-18Australian Commission on Safety and Quality in Health Care, Standard 27/04/2021

Used as Denominator

3.9 Average length of stay for hip fracture patients aged 65 years and over, major and large public hospitals, 2012–13 National Health Performance Authority (retired), Retired 01/07/2016
Australian Commission on Safety and Quality in Health Care, Standard 23/11/2016

6.9 Average length of stay for stroke patients aged 65 years and over, major and large public hospitals, 2012–13 National Health Performance Authority (retired), Retired 01/07/2016
Australian Commission on Safety and Quality in Health Care, Standard 23/11/2016

National Health Performance Authority, Hospital Performance: Percentage of people who received surgery for malignant cancer within 30 days, 2011-12 National Health Performance Authority (retired), Superseded 02/10/2014

National Health Performance Authority, Hospital Performance: Percentage of people who received surgery for malignant cancer within 30 days, 2012-13 National Health Performance Authority (retired), Retired 01/07/2016

National Health Performance Authority, Hospital Performance: Percentage of people who received surgery for malignant cancer within 45 days, 2011-12 National Health Performance Authority (retired), Superseded 02/10/2014

National Health Performance Authority, Hospital Performance: Percentage of people who received surgery for malignant cancer within 45 days, 2012-13 National Health Performance Authority (retired), Retired 01/07/2016

National Health Performance Authority, Hospital Performance: Percentage of people who waited longer than the clinical urgency category time for surgery for malignant cancer, 2011-12 National Health Performance Authority (retired), Retired 01/07/2016

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© Australian Institute of Health and Welfare
Version 1.0.0+20220531.2