Eyes Wide Open: Unveiling the Truth about Clinical Coding in Oculoplastic Procedures

    Hey there health-tech enthusiasts! Today, we’re going to talk about a fascinating study focusing on the accuracy of clinical coding in oculoplastic procedures, and the surprising financial implications that come along with it. So, buckle up as we dive into this intriguing research conducted by Valerie Juniat, Sarju Athwal, and Mona Khandwala.

    The Why and How of the Study

    You see, in England, hospitals get their funding through national tariffs set by NHS England. The amount of money a hospital gets hinges on the activities coded for each patient’s visit. However, when it comes to oculoplastics, there are no national standards or publications about coding accuracy. So, the researchers decided to roll up their sleeves and find out how accurate the coding was for oculoplastic procedures performed in their hospital.

    They did a deep dive into consecutive oculoplastic procedures performed at their hospital over six weeks. After discovering some interesting results, they whipped up a coding proforma to address the issues and then performed a re-audit using the same methods.

    So, What Did They Find?

    During the initial phase, they found that clinical coding was only ‘correct’ in 30.7% of the cases. Yikes! It was ‘incomplete’ for 12.9%, and hold onto your hats, ‘incorrect’ for a whopping 56.5%! The kicker? Over half of the ‘incorrect’ codes were labeled as non-oculoplastic procedures. Can you believe it?

    Having seen these shocking numbers, the researchers put their heads together with the coding team to figure out where they were going wrong. They then devised a nifty ‘tick box’ coding proforma, which the surgeons could fill out. When they did a re-audit, guess what? They saw a dramatic improvement in ‘correct’ coding, all the way up to 85.7%!

    What Does All This Mean?

    Clinical coding might seem like just a bunch of numbers and letters, but it’s a complex beast that’s vulnerable to inaccuracies. This study shed light on a high rate of coding error, but it also provided a beacon of hope – with collaboration, awareness, and handy tools like a coding proforma, it’s possible to drastically improve coding accuracy.

    And here’s the thing – accurate clinical coding isn’t just about getting it right for the sake of correctness. It has significant financial implications for hospitals. When we’re living in times of financial pressures, accurate coding could be the magic wand that helps make necessary savings. If this approach were applied across all specialties, who knows how much we could save, and how much more accurately we could track and treat our patients?

    So there you have it, folks! Clinical coding might not be the most glamorous part of healthcare, but it sure is crucial. Whether you’re a healthcare professional, a coder, or just someone interested in the field, let’s remember – every code counts!

    Sources:

    Juniat, V., Athwal, S. & Khandwala, M. Clinical coding and data quality in oculoplastic procedures. Eye 33, 1733–1740 (2019). https://doi.org/10.1038/s41433-019-0475-2

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