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Nadia Mcallister, Sumaira Macdonald, Carol Ewen

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. .

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Nadia Mcallister, Sumaira Macdonald, Carol Ewen

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  1. 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. • 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. • 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. • 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 Accuracy of coding for Interventional Radiology (IR) procedures to reflect on co-morbidities and complications (CC) during a hospital spell 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. Aims Results Materials and methods Conclusions Action Plan * Sensitive information ID number: 1757450

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