This audit highlights three main areas of concern under the new Payment by Results system – the inaccurate coding, the overly complex coding system and the inappropriate HRG rating for some procedures. We were, however, disappointed that the authors did not have any intervention to suggest to improve things. We feel that it is the clinicians' responsibility to make sure that their activity is properly coded and the NHS trust's responsibility to make sure that changes happen to make sure that there is appropriate payment for procedures.
In a previously published audit,1 we increased the accuracy of coding from 69% to 95% in a single cycle. This was done by:
Agreeing between consultants and the coding department on how different procedures should be coded.
Educating clinicians on the importance of coding and making them responsible for coding their procedures.
Weekly meetings between the coding department and a clinician to discuss difficult cases and educate the department on different procedures.
By addressing these fundamental areas of coding, we were able to produce a significant difference in coding accuracy.
References
- 1.Carr ERM, Pillai A. Audit of coding of operations. Clin Governance Bull. 2007;6:20–1. [Google Scholar]