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Episode of care—principal diagnosis, code (ICD-10-AM 9th 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 term588987
Registration status:Help on this term
  • Health, Superseded 05/10/2016
  • Independent Hospital Pricing Authority, Standard 16/03/2016
  • Tasmanian Health, Superseded 10/07/2017
Definition:Help on this term

The 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 9th 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 term

The 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
Supersedes 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
Has been superseded by Episode of care—principal diagnosis, code (ICD-10-AM 10th edn) ANN{.N[N]}
  • Health, Superseded 25/01/2018
  • Independent Hospital Pricing Authority, Recorded 04/08/2016
  • Tasmanian Health, Superseded 08/04/2019
Is used in the formation of Episode of admitted patient care—diagnosis related group, code (AR-DRG v 8.0) ANNA
  • Tasmanian Health, Superseded 11/01/2018
Implementation in Data Set Specifications:Help on this term
All attributes +

Activity based funding: Mental health care DSS 2016-17
Independent Hospital Pricing Authority, Superseded 28/02/2017

DSS specific attributes +

Implementation start date: 01/07/2016

Implementation end date: 30/06/2017

DSS specific information:

For admitted episodes of care it is mandatory for diagnosis to be reported in accordance with the Australian Coding Standards, and in ICD-10-AM 9th edition.

For ambulatory episodes of care, the diagnosis reported is the finalised diagnosis for the episode of care. A provisional diagnosis should only be reported if a finalised diagnosis cannot be obtained. It is mandatory for an ambulatory episode of care principal diagnosis to be reported in ICD-10-AM 9th edition.

For residential episodes of care, the principal diagnosis is reported in accordance with the Residential mental health care national minimum data set. It is mandatory for the principal diagnosis to be reported in ICD-10-AM 8th or 9th edition.


Admitted patient care NMDS 2015-16
Health, Superseded 10/11/2015

DSS specific attributes +

Implementation start date: 01/07/2015

Implementation end date: 30/06/2016

Conditional obligation:

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 2016-17
Health, Superseded 05/10/2016

DSS specific attributes +

Implementation start date: 01/07/2016

Implementation end date: 30/06/2017

Conditional obligation:

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 2015-16
Health, Superseded 19/11/2015

DSS specific attributes +

Implementation start date: 01/07/2015

Implementation end date: 30/06/2016


Admitted patient palliative care NMDS 2015-16
Health, Superseded 19/11/2015

DSS specific attributes +

Implementation start date: 01/07/2015

Implementation end date: 30/06/2016


Community mental health care NMDS 2016-17
Health, Superseded 17/08/2017

DSS specific attributes +

Implementation start date: 01/07/2016

Implementation end date: 30/06/2017

DSS specific information:

Codes can be used either 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 2016-17
Health, Superseded 17/08/2017

DSS specific attributes +

Implementation start date: 01/07/2016

Implementation end date: 30/06/2017

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).


Tasmanian Admitted Patient Data Set - 2016
Tasmanian Health, Superseded 10/01/2018

DSS specific attributes +

Implementation start date: 01/07/2016

Implementation end date: 30/06/2017


Implementation in Indicators:Help on this term
Used as Numerator

Australian Atlas of Healthcare Variation 2018: Number of thyroidectomy hospitalisations per 100,000 people aged 18 years and over, 2014-15 to 2016-17 Australian Commission on Safety and Quality in Health Care, Qualified 13/12/2018

Australian Health Performance Framework: PI 3.1.1–Incidence of heart attacks (acute coronary events), 2019 Health, Standard 09/04/2020

Australian Health Performance Framework: PI 3.1.5–Hospitalisation for injury and poisoning, 2019 Health, Standard 09/04/2020

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, 2018 Health, Superseded 19/06/2019

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, 2019 Health, Superseded 13/03/2020

National Healthcare Agreement: PI 09–Incidence of heart attacks (acute coronary events), 2018 Health, Superseded 19/06/2019

National Healthcare Agreement: PI 09–Incidence of heart attacks (acute coronary events), 2019 Health, Superseded 13/03/2020

National Healthcare Agreement: PI 18–Selected potentially preventable hospitalisations, 2018 Health, Superseded 19/06/2019

National Healthcare Agreement: PI 18–Selected potentially preventable hospitalisations, 2019 Health, Superseded 13/03/2020

National Healthcare Agreement: PI 23–Unplanned hospital readmission rates, 2018 Health, Superseded 19/06/2019

National Healthcare Agreement: PI 23–Unplanned hospital readmission rates, 2019 Health, Superseded 13/03/2020

National Healthcare Agreement: PI 27–Number of hospital patient days used by those eligible and waiting for residential aged care, 2018 Health, Superseded 19/06/2019

National Healthcare Agreement: PI 27–Number of hospital patient days used by those eligible and waiting for residential aged care, 2019 Health, Superseded 13/03/2020

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 2017-18 Australian Commission on Safety and Quality in Health Care, Standard 27/04/2021

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 2017-18 Australian 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 2017-18 Australian 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 2017-18 Australian 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 2017-18 Australian 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 2017-18 Australian Commission on Safety and Quality in Health Care, Standard 27/04/2021

Number of potentially preventable hospitalisations - cellulitis per 100,000 people of all ages, 2014-15 to 2017-18 Australian Commission on Safety and Quality in Health Care, Standard 27/04/2021

Number of potentially preventable hospitalisations - cellulitis per 100,000 people of all ages, 2014-15 to 2017-18 Australian Commission on Safety and Quality in Health Care, Standard 27/04/2021

Number of potentially preventable hospitalisations - chronic obstructive pulmonary disease (COPD) per 100,000 people of all ages, 2014-15 to 2017-18 Australian Commission on Safety and Quality in Health Care, Standard 27/04/2021

Number of potentially preventable hospitalisations - chronic obstructive pulmonary disease (COPD) per 100,000 people of all ages, 2014-15 to 2017-18 Australian Commission on Safety and Quality in Health Care, Standard 27/04/2021

Number of potentially preventable hospitalisations - diabetes complications per 100,000 people of all ages, 2014-15 to 2017-18 Australian Commission on Safety and Quality in Health Care, Standard 27/04/2021

Number of potentially preventable hospitalisations - diabetes complications per 100,000 people of all ages, 2014-15 to 2017-18 Australian Commission on Safety and Quality in Health Care, Standard 27/04/2021

Number of potentially preventable hospitalisations - heart failure per 100,000 people, of all ages, 2014-15 to 2017-18 Australian Commission on Safety and Quality in Health Care, Standard 27/04/2021

Number of potentially preventable hospitalisations - heart failure per 100,000 people, of all ages, 2014-15 to 2017-18 Australian Commission on Safety and Quality in Health Care, Standard 27/04/2021

Number of potentially preventable hospitalisations - kidney and urinary tract infections per 100,000 people of all ages, 2014-15 to 2017-18 Australian Commission on Safety and Quality in Health Care, Standard 27/04/2021

Number of potentially preventable hospitalisations - kidney and urinary tract infections per 100,000 people of all ages, 2014-15 to 2017-18 Australian Commission on Safety and Quality in Health Care, Standard 27/04/2021

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