Title : Cholecystectomy HRG coding
Abstract:
Introduction: Incorrect coding practices for surgical procedures carried out electively carries a significant financial burden on healthcare systems. In this study, we aimed to audit the coding practices pertaining to laparoscopic cholecystectomies within the NHS WWL Foundation Trust UK during November 21- October 22.
Method: A list of 194 patients undergoing a cholecystectomy along with their allocated HRG coding at time of discharge was compiled by the local coding department. A comorbidity and complication index (CCI) was calculated for each of these patients using the operation note together with hospital and GP records. With this information, the correct HRG coding fir each patient was calculated and compared to their allocated coding at discharge to calculate the difference in tariffs generated.
Results: 69.23% of 194 patients audited were allocated the wrong coding. This amounted to a financial burden of £72,232, with approximately £372 lost per cholecystectomy performed. Commonest CCI of 3 in 29% with corresponding HRG code GA10J.
Conclusions: High percentage of incorrectly coded procedures with significant financial implications. Current coding practice often incorrectly assumes comorbidity index.
Audience Take Away Notes:
- Coding practice in the UK and how Trusts are receive financial remuneration from the government
- Importance of correct coding practice
- Encouragement to review own local coding practice and investigate own discrepancies and consequent deleterious effects
