Why clinical coding is important for doctors
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A simple presentation aimed at hospital doctors to explain why coding is important and why the quality of discharge summaries has to be improved
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Why clinical coding is important for doctors
- 1. An idiot’s guide to PbR & why clinical coding is important Martin Gray
- 2. The language of PbR FCE finished consultant Spell patient activity,admission to discharge ICD-10 international classification of OPCS procedure HRG healthcare resource Grouper ICD/OPCS code information combine to generate HRG
- 3. The coding journey ✦ patient notes & DS completed by clinician ✦ coders assign ICD-10 code ✦ coders assign OPCS code ✦ information team pushes coded data through grouper to generate HRG ✦ HRG grouped activity is then assigned a cost ✦ Hospital receives payment at national tariff level
- 4. Format of HRG4 PA 15 B
- 5. Format of HRG4 Acute Respiratory PA 15 B
- 6. Format of HRG4 Acute Respiratory PA 15 B Chapter
- 7. Format of HRG4 Acute Respiratory PA 15 B Chapter Subchapter
- 8. Format of HRG4 Acute Respiratory Number PA 15 B Chapter Subchapter
- 9. Format of HRG4 Acute Respiratory Number Split PA 15 B Chapter Subchapter
- 10. Format of HRG4 Acute Respiratory Number Split PA 15 B Chapter In this case ‘B’ means no complication Subchapter
- 11. Format of HRG4 Acute Respiratory Number Split PA 15 B Chapter In this case ‘B’ means no complication Subchapter Acute Bronchiolitis with no complication or comorbidity
- 12. Format of HRG4 PA 15 A
- 13. Format of HRG4 Acute Respiratory PA 15 A
- 14. Format of HRG4 Acute Respiratory PA 15 A Chapter
- 15. Format of HRG4 Acute Respiratory PA 15 A Chapter Subchapter
- 16. Format of HRG4 Acute Respiratory Number PA 15 A Chapter Subchapter
- 17. Format of HRG4 Acute Respiratory Number Split PA 15 A Chapter Subchapter
- 18. Format of HRG4 Acute Respiratory Number Split PA 15 A Chapter In this case ‘A’ means with complication Subchapter
- 19. Format of HRG4 Acute Respiratory Number Split PA 15 A Chapter In this case ‘A’ means with complication Subchapter Acute Bronchiolitis with complication or comorbidity
- 20. Cost breakdown ✦ PA15B - Bronchiolitis ✦ Basic Tariff for admission £943 ✦ Trim point 8 days ✦ Tariff per day for long stays £280/day ✦ 5 day Bronchiolitis admission £943
- 21. Cost breakdown ✦ PA15A - Bronchiolitis with comorbidity or complication ✦ Basic Tariff for admission £2005 ✦ Trim point 14 days ✦ Tariff per day for long stays £280/day ✦ 5 day Bronchiolitis admission £2005
- 22. Spells, Unbundling & FCEs FCE FCE FCE FCE FCE
- 23. Spells, Unbundling & FCEs FCE FCE FCE FCE FCE RA01Z ➡ MRI scan XD23Z ➡ High Cost Drug XB02Z ➡ PICU QZ14B ➡ PICC Line Unbundled ➡ Palliative Care HRGs SD04B
- 24. Spells, Unbundling & FCEs FCE HRGs grouped from all the FCE procedures and diagnoses in the FCE FCE FCE FCE FCE RA01Z ➡ MRI scan XD23Z ➡ High Cost Drug XB02Z ➡ PICU QZ14B ➡ PICC Line Unbundled ➡ Palliative Care HRGs SD04B
- 25. Spells, Unbundling & FCEs FCE HRGs grouped from all the FCE procedures and diagnoses in the FCE FCE FCE PA15B FCE FCE Spell HRG grouped from all the procedures and diagnoses in the Spell RA01Z ➡ MRI scan XD23Z ➡ High Cost Drug XB02Z ➡ PICU QZ14B ➡ PICC Line Unbundled ➡ Palliative Care HRGs SD04B
- 26. Spells, Unbundling & FCEs FCE HRGs grouped from all the FCE procedures and diagnoses in the FCE FCE FCE PA15B You can get one core and one or more unbundled HRGs per FCE FCE/Spell FCE Spell HRG grouped from all the procedures and diagnoses in the Spell RA01Z ➡ MRI scan XD23Z ➡ High Cost Drug XB02Z ➡ PICU QZ14B ➡ PICC Line Unbundled ➡ Palliative Care HRGs SD04B
- 27. Spells, Unbundling & FCEs FCE HRGs grouped from all the FCE procedures and diagnoses in the FCE FCE FCE PA15B You can get one core and one or more unbundled HRGs per FCE FCE/Spell FCE Spell HRG grouped from all the Individual FCE HRGs may be procedures and different from the Spell HRG diagnoses in the Spell RA01Z ➡ MRI scan XD23Z ➡ High Cost Drug XB02Z ➡ PICU QZ14B ➡ PICC Line Unbundled ➡ Palliative Care HRGs SD04B
- 29. The discharge summary Main Diagnosis
- 30. The discharge summary Main Diagnosis Chest infection
- 31. The discharge summary Main Diagnosis Chest infection Co-morbidities
- 32. The discharge summary Main Diagnosis Chest infection Co-morbidities Investigations
- 33. The discharge summary Main Diagnosis Chest infection Co-morbidities Investigations Procedures
- 34. The discharge summary Main Diagnosis Chest infection Co-morbidities Investigations Procedures High cost drugs
- 35. The discharge summary Main Diagnosis Chest infection Co-morbidities Investigations Procedures High cost drugs = Basic tariff
- 37. The discharge summary Main Diagnosis
- 38. The discharge summary Main Diagnosis Chest infection
- 39. The discharge summary Main Diagnosis Chest infection Co-morbidities
- 40. The discharge summary Main Diagnosis Chest infection Co-morbidities Leukaemia
- 41. The discharge summary Main Diagnosis Chest infection Co-morbidities Leukaemia Investigations
- 42. The discharge summary Main Diagnosis Chest infection Co-morbidities Leukaemia Investigations CT chest
- 43. The discharge summary Main Diagnosis Chest infection Co-morbidities Leukaemia Investigations CT chest Procedures
- 44. The discharge summary Main Diagnosis Chest infection Co-morbidities Leukaemia Investigations CT chest Procedures PICC line
- 45. The discharge summary Main Diagnosis Chest infection Co-morbidities Leukaemia Investigations CT chest Procedures PICC line High cost drugs
- 46. The discharge summary Main Diagnosis Chest infection Co-morbidities Leukaemia Investigations CT chest Procedures PICC line High cost drugs Antifungals
- 47. The discharge summary Main Diagnosis Chest infection Co-morbidities Leukaemia Investigations CT chest Procedures PICC line High cost drugs Antifungals = Enhanced tariff
- 48. The quality of Discharge Summaries is fundamental to our revenue generating capabilities
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