[WWW - 2023.07.31]
Identifying and Definitional Attributes
QH 041644 v12
Data Element
Data Element
Draft
12-Dec-2018
Current
19-Nov-2019
Superseded
15-May-2023
Standard
Information Management Strategic Governance Committee (IMSGC), Queensland Health
01-Jul-2019
30-Jun-2022
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 a health care establishment, as represented by a code.
Health services
Principal diagnosis (ICD-10-AM)
PD
Representational Attributes
Character
Code
ANN{.N[N]}
3
6
Permissible Values

Permissible_values

A valid 11th edition code from the corporate reference data system (CRDS) ICD-10-AM data set maintained by Statistical Standards and Strategies, Statistical Services Branch (SSB).
Supplementary Values

Supplemenary_values

-
Collection and Usage Attributes
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 the International statistical classification of diseases and related health problems, 10th revision, Australian modification (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.

Australian Coding Standard 0050 Unacceptable principal diagnosis codes provides guidance as to those codes that cannot be assigned.

Diagnosis codes starting with a U (only U50-U73), 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 within the code range U78-U88 are supplementary codes for chronic conditions and cannot be used as principal diagnosis.

Diagnosis codes within the code range U92 are healthcare associated infections and cannot be used as principal diagnosis.

Diagnosis codes which are morphology codes cannot be used as principal diagnosis.
Must be a valid ICD-10-AM 11th edition code.
ICD-10-AM codes are validated against a number of national and state edits (e.g. age, sex, cannot be PD, rare, combination, COF, etc.) to improve coding quality.

Clinical Costing Data Repository (CCDR):
Must not be null for:
- Admitted Acute
- Admitted Sub-Acute
- Emergency
- Mental Health
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 abstracted from and must be substantiated by clinical documentation.

Queensland Hospital Admitted Patient Data Collection (QHAPDC):
The principal diagnosis should be sequenced first in the string of codes.
Punctuation is excluded in QHAPDC.
A Principal diagnosis should be recorded for each episode of patient care. Where the principal diagnosis is recorded prior to discharge (as in annual census of public psychiatric hospital inpatients), 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.
This data element is used for epidemiological research, casemix studies and planning purposes.
Queensland Hospital Admitted Patient Data Collection (QHAPDC):
AR-DRG Version 10.0 is for use with ICD-10-AM/ACHI 11th edition codes;
- for 2019-20 Version 9.0 will be reported
- for 2020-21 Version 10.0 will be reported.
Relational Attributes
Related Metadata References

Related Metadata References_IR

  • 1 - 11
ViewRelationshipMetadata Item TypeMetadata Item SubtypeNameIdentifier & VersionApproval Status
SupersedesData ElementData ElementEpisode of care-principal diagnosis code (ICD-10-AM 10th edn)QH 041644 Version 11Superseded
Is qualified byData ElementData ElementEpisode of admitted patient care-diagnosis code prefix (ICD-10-AM) (HBCIS)QH 041645 Version 4Superseded
Is used in the derivation ofData ElementDerived Data ElementEpisode of admitted patient care-diagnosis related group (AR-DRG v10.0)QH 041587 Version 11Current
Is used in the derivation ofData ElementDerived Data ElementEpisode of admitted patient care-major diagnostic category (AR-DRG v10.0)QH 041588 Version 11Current
Relates toData ElementData ElementEpisode of care-additional diagnosis code (ICD-10-AM 11th edn)QH 041646 Version 12Superseded
Relates toData ElementData ElementEpisode of care-clinical code (ICD-10-AM/ACHI 11th edn)QH 040100 Version 5Superseded
Relates toData ElementData ElementEpisode of care-morphology of neoplasm code (ICD-10-AM 11th edn)QH 041688 Version 11Superseded
Relates toData ElementData Element ConceptDiagnosisQH 040789 Version 2Current
Relates toData ElementData Element ConceptEpisode of careQH 041640 Version 1Current
Relates toData ElementData Element ConceptPrincipal diagnosis (ICD-10-AM)QH 040244 Version 2Current
Relates toData ElementData Element ConceptProcedure (ACHI)QH 040617 Version 2Superseded
Implementation in Metadata Sets

Implemented

  • 1 - 1
ViewMetadata Item TypeMetadata Item SubtypeNameIdentifer & VersionObligationApproval StatusEffective FromEffective To
Information AssetData CollectionQueensland Hospital Admitted Patient Data Collection (QHAPDC)QH 020001 Version 2MandatoryCurrent01-Jul-201930-Jun-2022
Source and Reference Attributes
Australian Institute of Health and Welfare
METeOR data element: Episode of care-principal diagnosis, code (ICD-10-AM 11th edn) ANN{.N[N]}, identifier 699609, Health Standard 12/12/2018 https://meteor.aihw.gov.au/content/index.phtml/itemId/699609/meteorItemView/long