Accident and emergency clinical codes

Accident and emergency (A&E;) clinical codes are used to record the diagnoses, investigations and treatments made during an accident and emergency attendance.

While ICD-10 and OPCS-4 codes can be recorded against A&E; attendances, it is the A&E; clinical codes (A&E; Diagnosis, A&E; Investigation and A&E; Treatment) which are mandated to flow within the data set and it is these codes which are made available within the A&E; HES data.

The coding schemes currently used within the A&E; HES data are described in more detail in the following sections.

A&E; Diagnosis

A&E; Diagnosis codes record the patient diagnosis for an A&E; attendance. The codes are made up of four parts, the diagnosis condition, the diagnosis condition sub-analysis, the anatomical area and the anatomical side. The diagnosis condition sub-analysis is only applicable to certain diagnosis conditions.

Each A&E; Diagnosis code is a six character code and is broken down as follows:

• The first two characters contain the diagnosis condition. Values range between 01 and 39.
• The third character may contain the sub-analysis of the diagnosis condition (where applicable). This is used to specify the diagnosis condition more precisely. Values range between 1 and 5. This value should be left blank and a space inserted if no sub analysis is applicable.
• The fourth and fifth characters contain the anatomical area of the body relating to the clinical problem being diagnosed. Values range between 01 and 36.
• The sixth character contains the anatomical side of the body relating to the clinical problem being diagnosed. Values for this field should be L (left), R (right), B (bilateral) or 8 (not applicable).

An example of an A&E; Diagnosis code which has a sub-analysis would be '10216R' (Burns and scalds-Thermal-Hand-Right). An example of an A&E; Diagnosis code which does not have a sub-analysis would be '06�33L' (Sprain/ligament injury-Ankle-Left).

A&E; Investigation

The A&E; Investigation code records the types of investigation that may be requested during an A&E; attendance to assist with a diagnosis. The A&E; Investigation code is made up of two parts, the investigation that took place and a sub-analysis which is for local use only.

The A&E; Investigation code is a six character code and is broken down as follows:

• The first two characters contain the type of investigation conducted. Values range between 01 and 24. A value of 99 ('Other') can also be entered.
• Characters three to six inclusive can be used to record a sub-analysis and are for local use only.

An example of an A&E; Investigation code which does not have a local sub-analysis would be '05' (Biochemistry). An example of an A&E; Investigation code which does have a local sub-analysis would be '150001' (Immunology-Local sub-analysis code).

A&E; Treatment

The A&E; Treatment code records the types of treatment or guidance that a patient may receive during an A&E; attendance. The A&E; Treatment code is made up of three parts, the treatment condition, the treatment condition sub-analysis and a local use section. The treatment condition sub-analysis is only applicable to certain treatment conditions.

The A&E; Treatment code is a six character code and is broken down as follows:

• The first two characters contains the treatment condition which provides information relating to the treatment received during an A&E; attendance. Values range between 01 to 25 and 27 to 57. A value of 99 ('Other') can also be entered.
• The third character may contain the sub-analysis of the treatment condition (where applicable). This is used to specify the treatment condition more precisely. Values range between 1 and 9. This value should be left blank and a space inserted if no sub-analysis is applicable.
• Characters four to six inclusive are for local use only.

An example of an A&E; Treatment code which has a sub-analysis would be '032001' (Sutures-Secondary/complex suture-Local use). An example of an A&E; Treatment code which does not have a sub-analysis would be '39 001' (Oral airway-Local use).

Further information relating to the A&E; clinical codes contained within the A&E; HES data can be found in the A&E; HES Data Dictionary.