‘Adverse effects of correct substances properly administered are classified according to the nature of the adverse effect.’
There is no other instruction (other than the need for an external cause to be used – which reinforces an existing standard), just an example.
Analysis of ACS 1902 Adverse Effects was undertaken by applying 4 principles of quality standards and data:
a) Use consistent terminology
The text “According to the nature of the adverse effect” – appears to be saying that the coder should code the manifestation e.g. rash. This is an example of use of inconsistent terminology in the standard where “manifestation” is commonly used, and a new phrase (the nature of the adverse effect) has been added for this standard.
b) Consistency across all coding and standards.
See ACS 1901 poisoning which has a different approach to ACS 1902
c) Document the rule in a way that is easy to understand.
Our interpretation of the standard written in a repeatable and actionable manner:
This method of explaining the standard has only one interpretation and applies to all examples of the situation, rather than being dependent upon an example. Examples should support the standard not be used to explain it or extend it.
The rationale for this standard is that the manifestation together with the cause of injury code tells the whole story.
This is consistent with good data practice which does not mix the scope of concepts (Cimino, 1998) The concept of the injury is one thing, while the concept of the cause and place is another. Together these tell the whole story.