Nadia Mcallister, Sumaira Macdonald, Carol Ewen

Accuracy of coding for IR procedures is crucial in determining the correct healthcare resource group (HRG) tariff from which the cost of a hospital spell is reimbursed to the trust.

Accuracy of coding for Interventional Radiology (IR) procedures to reflect on co-morbidities and complications (CC) during a hospital spell

Materials and methods

• 100 consecutive cases dating March-April 2012• Collected from IR database • 59 cases used excluded devices• 93 out of 100 cases were suitable for a final analysis of HRG tariffs: 2 cases

were not coded as were considered as OP admissions, 5 cases had ≥2 IR procedures done during one hospital spell and therefore had duplicate coding summaries.

Results Aims

Conclusions

• Explore the coding pathway for IR-related admissions.• Investigate the process of recording and reimbursement of the excluded

devices list to the IR department.• Investigate the accuracy of recording of Co-morbidities and Complications to

reflect on the appropriate tariff applied.

• 3 out of 59 cases were missed from the excluded devices list (2%), generating a total loss of £3187.92 (including VAT) to the IR department.

• Estimated loss of £41,688 to the IR department annually. • 6 out of 93 cases (7%) were allocated the incorrect HRG

tariff generating a net loss of £11,970 (excluding VAT) to the trust.• * Estimated loss to the trust annually.

Action Plan

• Raise awareness amongst staff:• Importance of clear documentation in the notes• Full record of co-morbidities • Accurate recollection of complications• Importance of registering all devices used during an IR procedure

• Improve discharge letter template to account for CC.• Improve electronic sources (Diadem) for the recording of co-

morbidities. • Employ reliable and cost-effective strategies to improve the

existing system for recording of excluded devices. • Manual collection of data by the designated team in Interventional Radiology. • Introduction of the bar code system for IR department.

• ? Cost

• Accurate identification of excluded devices allows patients’ access to novel and effective yet expensive technologies.

• The root cause analysis was carried out for all cases identified which included failures at both junior and senior levels.

* Sensitive information

ID number: 1757450