1 / 17

Coding of Radiological Examinations

Coding of Radiological Examinations. By Dr Anosike, Dr Katti and Dr Nedumaran Department of Radiology University Hospital Aintree. Aims and objectives. To assess the accuracy of coding CT, MRI and Ultrasound examinations carried out in the department between February and April 2009

montego-vazquez
Download Presentation

Coding of Radiological Examinations

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Coding of Radiological Examinations By Dr Anosike, Dr Katti and Dr Nedumaran Department of Radiology University Hospital Aintree

  2. Aims and objectives To assess the accuracy of coding CT, MRI and Ultrasound examinations carried out in the department between February and April 2009 To determine if there is repetition of examinations due to inappropriate coding To look at the impact of inappropriate coding  

  3. Standard No literature available Locally agreed standard. The coding should be 100% accurate in keeping with the coding system of the Radiology department 

  4. Why coding is important? • To avoid repetition of examinations that can result from inappropriate coding (including IRMER where appropriate) • Accurate reflection of the workload of the department. • Coding can have financial implications for the department and the trust

  5. Methodology • 100 CT, MRI and Ultrasound examinations between February and April 2009 were sampled. • The request cards were looked at and the coding on the CRIS system was recorded. • The allocated code was compared with the radiology images to determine whether the coding was appropriate for the examination carried out. • Appropriate coding was retrospectively assigned.

  6. Ultrasound = 94 were compliant and 6 non compliant. 1 scan was inappropriately repeated CT = 53 were properly coded, while 47 were non compliant. No repetition MRI = 86 were properly coded while 14 were non compliant. 2 scans inappropriately repeated Summary of results

  7. Total scans per year in Aintree Hospital Ultrasound = 21222 per year = 70/working day CT = 22268 per year = 55/day MRI = 9568per year = 25/day

  8. Impact on Departmental workload

  9. Repetition of examinations Ultrasound = 1 scan per 100 was inappropriately repeated = 212 repeat exams per year (3 working days - 70/day) CT = No inappropriate repetitions found!! – most likely due to sampling error (small sample of 100 compared to 22268 CT exams performed at Aintree - 55/day) MRI = 2 scans were inappropriately repeated = 191 repeat exams per year (8 working days - 25/day)

  10. CT coding - implications • Difference between 1 area post contrast and 3 areas post contrast is £ 20. Eg. chest/abdomen/pelvis coded as CCHES only • Difference between 1 area no contrast and more than 3 areas with contrast is £ 51. Eg. head/chest/abdomen/pelvis coded as CSKUH only in trauma patients.

  11. CT coding - implications • Non compliant coding = 47 per 100 scans • Non compliant coding = 10466 exams out of 22268 per year • COST DEFICIT = £ 640 per 100 CT scans • COST DEFICIT projected for 1 year = £ 142515.20

  12. MRI coding - implications • Difference between 1 area no contrast and 2/3 areas no contrast is £ 101. Eg. Brain and neck coded as MSKUH (brain) only • Difference between 1 area no contrast and 2/3 areas with contrast is £ 146. Eg brain and carotids with contrast coded as MSKUH (brain) only.

  13. MRI coding - implications • Non compliant coding = 14 per 100 scans • Non compliant coding = 1340 exams out of 9568 per year • COST DEFICIT = £ 701 per 100 MR scans • COST DEFICIT Projected for 1 year = £ 67071.68

  14. US coding - implications • Non compliant = 6 scans • COST DEFICIT = difficult to calculate but difference is substantial • Need further information • Is it based on • scanning time – if so when – patient enters room or probe on patient • appointment slot – poor co operation or difficult patient

  15. Summary of Recommendations • Educate/train all radiology staff on the coding system. • Modify existing coding system • to reflect on clinical practice • Avoid duplication of codes • avoid too many overlaps • Agree appropriate coding for staging examinations. • A re-audit in 12 months was recommended.

  16. Summary of Re-audit results • Ultrasound = 99 were compliant and 1 non compliant. No repetition. • CT = 85 were properly coded, while 15 were non compliant. No repetition • MRI = 92 were properly coded while 8 were non compliant. No repetition.

  17. Conclusion. • There needs to be regular re-auditing of the coding of radiological examinations to make sure that standards are maintained. • The codes need to be regularly revised to ensure that they correctly reflect the work done in the radiology department.

More Related