Unraveling the World of Clinical Coding: An Insight into ICD-10 and OPCS in Local Anaesthetic and IV Sedation Cases

Hello, health enthusiasts! In today’s post, we’ll be journeying into the fascinating world of clinical coding. Ever wondered how the treatments offered by healthcare trusts are translated into a system for organising payments? It’s all down to the magic of clinical coding.

We recently came across a compelling study conducted by S.S. Dubb, P. Parmar, and A.V. Parbhoo, three incredibly talented individuals who ventured into the niche of clinical coding in elective local anaesthetic and IV sedation cases. Their main goal was to determine the accuracy of ICD and OPCS codes generated in this context and explore factors that could cause inaccuracies.

But first, what are ICD and OPCS codes?

To those unfamiliar, ICD stands for International Classification of Diseases. This globally recognized system allows healthcare providers to track diseases and health conditions systematically. On the other hand, OPCS (Office of Population Censuses and Surveys Classification of Interventions and Procedures) codes are used in the UK to detail surgical, diagnostic, and therapeutic procedures.

The audit trail…

The authors performed an audit within their OMFS (Oral and Maxillofacial Surgery) department. Their approach was to review all local anaesthetic and IV sedation cases at two separate 3-month intervals, with 100 cases per cycle.

They aimed high, setting a gold standard of 100% for recording coding information and accuracy. In the first cycle, they identified areas of improvement and, with these findings, they introduced a new clinical coding form. Then, they moved on to the second cycle, using the newly improved form.

So, what did they find?

Well, here’s where it gets interesting. In the first cycle, the accuracy of the primary diagnoses, based on ICD-10 coding, was at 65%. But after they made improvements, this figure jumped to 72% in the second cycle. Isn’t it amazing what a few tweaks can do?

Similarly, for OPCS coding, they saw an accuracy rate of 80% in the first cycle, which improved to an impressive 90% in the second cycle. Even secondary or bilateral procedures showed improvement from 83% to 89% in the second cycle.

And the monetary aspect?

The audit cycle generated a whopping £20,000 of revenue. This reveals a crucial point – inaccuracies in clinical coding can lead to significant revenue loss. By improving our understanding of where errors occur, we can ensure that income aligns better with clinical activity.

Wrapping up…

Clinical coding might seem like an alien concept to many, but its impact on the healthcare industry is undeniable. The study we’ve discussed today highlights the importance of accurate coding and the need for constant evaluation to eliminate potential inaccuracies.

Stay tuned for more such interesting insights into the world of healthcare. Until next time, stay healthy, stay curious!

Sources:
S.S. Dubb, P. Parmar, A.V. Parbhoo, Clinical coding of ICD-10 and OPCS in elective local anaesthetic and IV sedation cases, British Journal of Oral and Maxillofacial Surgery, Volume 59, Issue 8, 2021, Pages 894-897,
ISSN 0266-4356, https://www.sciencedirect.com/science/article/abs/pii/S0266435620309529