Episode of care—additional diagnosis, code (ICD-10-AM 6th edn) ANN{.N[N]}

Identifying and definitional attributes

Metadata item type:Data Element
Short name:Additional diagnosis
METeOR identifier:356587
Registration status:Health, Superseded 22/12/2009
Definition:A condition or complaint either coexisting with the principal diagnosis or arising during the episode of admitted patient care, episode of residential care or attendance at a health care establishment, as represented by a code.
Data Element Concept:Episode of care—additional diagnosis

Value domain attributes

Representational attributes

Classification scheme:International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification 6th edition
Representation class:Code
Data type:String
Format:ANN{.N[N]}
Maximum character length:6

Data element attributes

Collection and usage attributes

Guide for use:

Record each additional diagnosis relevant to the episode of care in accordance with the ICD-10-AM Australian Coding Standards. Generally, external cause, place of occurrence and activity codes will be included in the string of additional diagnosis codes. In some data collections these codes may also be copied into specific fields.

The diagnosis can include a disease, condition, injury, poisoning, sign, symptom, abnormal finding, complaint, or other factor influencing health status.

Additional diagnoses give information on the conditions that are significant in terms of treatment required, investigations needed and resources used during the episode of care. They are used for casemix analyses relating to severity of illness and for correct classification of patients into Australian Refined Diagnosis Related Groups (AR-DRGs).

Collection methods:An additional diagnosis should be recorded and coded where appropriate upon separation of an episode of admitted patient care or the end of an episode of residential care. The additional diagnosis is derived from and must be substantiated by clinical documentation.
Comments:

Additional diagnoses should be interpreted as conditions that affect patient management in terms of requiring any of the following:

  • Commencement, alteration or adjustment of therapeutic treatment
  • Diagnostic procedures
  • Increased clinical care and/or monitoring

In accordance with the Australian Coding Standards, certain conditions that do not meet the above criteria may also be recorded as additional diagnoses.

Additional diagnoses are significant for the allocation of Australian Refined Diagnosis Related Groups. The allocation of patient to major problem or complication and co-morbidity Diagnosis Related Groups is made on the basis of the presence of certain specified additional diagnoses. Additional diagnoses should be recorded when relevant to the patient's episode of care and not restricted by the number of fields on the morbidity form or computer screen.

External cause codes, although not diagnosis of condition codes, should be sequenced together with the additional diagnosis codes so that meaning is given to the data for use in injury surveillance and other monitoring activities.

Source and reference attributes

Origin:National Centre for Classification in Health

Relational attributes

Related metadata references:

Supersedes Episode of care—additional diagnosis, code (ICD-10-AM 5th edn) ANN{.N[N]} Health, Superseded 05/02/2008

Has been superseded by Episode of care—additional diagnosis, code (ICD-10-AM 7th edn) ANN{.N[N]} Health, Superseded 02/05/2013, Commonwealth Department of Health, Candidate 16/07/2015, National Health Performance Authority (retired), Retired 01/07/2016

Implementation in Data Set Specifications:
All attributes +

Admitted patient care NMDS 2008-09 Health, Superseded 04/02/2009

DSS specific attributes +

Admitted patient care NMDS 2009-10 Health, Superseded 22/12/2009

DSS specific attributes +

Admitted patient mental health care NMDS 2008-09 Health, Superseded 04/02/2009

DSS specific attributes +

Admitted patient mental health care NMDS 2009-10 Health, Superseded 05/01/2010

DSS specific attributes +

Admitted patient palliative care NMDS 2008-09 Health, Superseded 04/02/2009

DSS specific attributes +

Admitted patient palliative care NMDS 2009-10 Health, Superseded 05/01/2010

DSS specific attributes +

Residential mental health care NMDS 2008-09 Health, Superseded 04/02/2009

DSS specific attributes +

Residential mental health care NMDS 2009-10 Health, Superseded 05/01/2010

DSS specific attributes +
Implementation in Indicators:Used as numerator
National Healthcare Agreement: PB 07-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, 2011 Health, Superseded 30/10/2011
National Healthcare Agreement: PB 07-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, 2012 Health, Superseded 25/06/2013
National Healthcare Agreement: PI 02-Incidence of selected cancers, 2015 Health, Superseded 08/07/2016
National Healthcare Agreement: PI 04-Incidence of selected cancers, 2011 Health, Superseded 30/10/2011
National Healthcare Agreement: PI 04-Incidence of selected cancers, 2012 Health, Superseded 25/06/2013
National Healthcare Agreement: PI 22-Selected potentially preventable hospitalisations, 2011 Health, Superseded 31/10/2011
National Healthcare Agreement: PI 22-Selected potentially preventable hospitalisations, 2012 Health, Superseded 25/06/2013
National Healthcare Agreement: PI 41-Falls resulting in patient harm in hospitals, 2011 Health, Superseded 31/10/2011
National Healthcare Agreement: PI 41-Falls resulting in patient harm in hospitals, 2012 Health, Retired 25/06/2013
National Healthcare Agreement: PI 42-Intentional self-harm in hospitals, 2011 Health, Superseded 31/10/2011
National Healthcare Agreement: PI 42-Intentional self-harm in hospitals, 2012 Health, Retired 25/06/2013
National Healthcare Agreement: PI 57-Hospital patient days used by those eligible and waiting for residential aged care, 2011 Health, Superseded 31/10/2011
National Healthcare Agreement: PI 57-Hospital patient days used by those eligible and waiting for residential aged care, 2012 Health, Superseded 25/06/2013