CCAM
name	Classification Commune des Actes Medicaux
summary	Common Classification Of Medical Procedures. Forms part of the Classification Commune des Professions de Santé (CCPS), the Shared Classification of Health Professionals.
clinical focus	All clinical procedures.
developed by	"This classification was developed through a partnership between (French) Department of Health and health insurance bodies" [ATIH]. The development group comprised physicians and experts from the government agency, ATIH (Agence Technique de l'information sur l'Hospitalisation), and from the nomenclature division of the [French] National Health Insurance Agency for Wage Earners (CNAMTS) as well as representatives from 30 national colleges of medical specialties and partners from the EU R&D project, Galen-In-Use.
introduced	Version 0 released on 1 January 2002.
current version	Version V1: released on 1 January 2006.
background / derivation	CCAM was developed both in the traditional expert consensus fashion by groups of experts organised by clinical specialty using their specific terms, and through a collaboration of European University and research centres using ontology-driven and natural language processing terminology tools developed by the GALEN project. The main software used in the development of CCAM was the GALEN Classification Workbench (ClaW), an ontology-driven toolset designed to support the creation and maintenance of classification schemes. (The ClaW has now been commercialised by Kermanog BV in the Netherlands.)
features	CCAM is a multi-hierarchical classification - not simply a flat list of procedures. "CCAM ... codes [support] not only medical analysis and research ... but also processing to calculate pricing for payment per private practitioner procedure, and hospitalisation classification into GHMs (Groupes Homogènes de Malades - Diagnosis Related Groups) for pricing per healthcare facility activity." The scope of CCAM is currently limited to physician and dental surgeon procedures but is to be extended to any type of Healthcare Professional procedures within CCPS. In France, CCAM has replaced the medical procedures catalogue (CdAM) in the hospital sector (PMSI/DRG/T2A program) and the NGAP (General Professional Procedure Nomenclature) for payment-per-private-practitioner procedures. New procedures generally have to be validated for inclusion into CCAM by la Haute Autorité de Santé (HAS - formerly ANAES). However, procedures that form part of a clinical research protocol may be included. Guidelines for the use of CCAM descriptions and codes are available.
standards	Conforms with CEN AFNOR standard EN 1828.
in use	"Regulatory procedure coding tool for the [French] medical information system programme [PMSI:DRG/T2A] since January 1, 2004". Mandatory cosing system for procedures carried out by fee-charging private physicians from 1 January 2006
access	"Files enabling ... CCAM to be incorporated into coding assistance computer software are freely available on the CNAMTS web site. ATIH provides freely available PDF and HTML versions of the corpus and guidelines [for use]. More sophisticated products (API, PAULINE coding and thesaurus creation assistance tool) are also available from ... ATIH. [The] Official Bulletin “2003-7 bis” gives the list of codes and descriptions used in the CCAM version “0 bis”."
tools	See: l'Assurance Maladie en ligne - Caisse Nationale d'Assurance Maladie Des Travailleurs Salariés (CNAMTS)
references
Rodrigues JM, Rector A, Zanstra P et al. An Ontology driven collaborative development for biomedical terminologies: from the French CCAM to the Australian ICHI coding system. Stud Health Technol Inform. 2006;124:863-868. [PubMed]   [] " The CCAM French coding system of clinical procedures was developed between 1994 and 2004 using, in parallel, a traditional domain expert's consensus method on one hand, and advanced methodologies of ontology driven semantic representation and multilingual generation on the other hand. These advanced methodologies were applied under the framework of an European Union collaborative research project named GALEN and produced a new generation of biomedical terminology. Following the interest in several countries and in WHO, the GALEN network has tested the application of the ontology driven tools to the existing reduced Australian ICHI coding system for interventions presently under investigation by WHO to check its ability and appropriateness to become the reference international coding system for procedures. The initial results are presented and discussed in terms of feasibility and quality assurance for sharing and maintaining consistent medical knowledge and allowing diversity in linguistic expressiveness of end users. " Hanser S, Zaiss A, Schulz S. Comparison of ICHI and CCAM Basic Coding System. Stud Health Technol Inform. 2006;124:795-800. [PubMed]   [] " While diagnoses are coded by ICD across the world, there is no universally accepted coding system for procedures. In many countries there exists not even a local classification for medical procedures. As a possible solution the International Classification of Health Interventions (ICHI) has been proposed as a common denominator for an international procedure classification. We alternatively postulate a multiaxial framework for procedure classification following the French Classification Commune des Actes Medicaux (CCAM) for the generation of a procedure shortlist. We compared ICHI and CCAM Basic Coding System focusing on the appropriateness of both systems for supporting the comparability of procedure data. Considering the ongoing standardization of health terminologies and classifications, we strongly recommend to improve the ICHI structure, capitalizing on the benefits of the CCAM architecture. "
contact	l'Assurance Maladie en ligne - Caisse Nationale d'Assurance Maladie Des Travailleurs Salariés (CNAMTS)
links	CCAM    Agence Technique de l'information sur l'Hospitalisation (ATIH) ("technical hospitalisation information agency")    l'Assurance Maladie en ligne - Caisse Nationale d'Assurance Maladie Des Travailleurs Salariés (CNAMTS)     La Haute Autorité de Santé (agency formerly l'Agence Nationale d'Accréditation et d'Évaluation en Santé (ANAES), la Commission de la transparence et la Commission d'évaluation des produits et prestations)    Kermanog [OC]    Kermanog Classification Workbench (ClaW): time-limited version for evaluation [OC]
acknowledgements
Jean-Marie Rodrigues, Dept. of Public Health and Medical Informatics , University of Saint Etienne USE, France
page history
Entry on OpenClinical: 16 November 2006 Last main update: 22 November 2006