Filling Feeder Gaps using ICD codes
Join Philip Moore as he discusses the importance of feeder gaps and the utilization of ICD service codes over traditional DRG methods. This session covers the setup process in the Patient Pathway Management (PPM) system and explores case studies like organ retrievals and implants. Learn how to obtain and adapt data from external DHBs, create new service codes, and ensure accurate coding for allied health services. Engage in discussions about practical applications and enhancements in patient-level data utilization at the Auckland District Health Board.
Filling Feeder Gaps using ICD codes
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Presentation Transcript
2008 PPM User Conference Filling Feeder Gapsusing ICD codes Philip Moore
Agenda • Overview • Auckland example – Implants • Method in PPM • Exercise – Allied Health • Discussion – other areas
Overview • What are feeder gaps? • Why use ICD service codes vs DRG only • How set them up
ADHB - Implants • No patient level data available • Obtained data from another DHB with patient level implant data • Adjusted for local practice • Cost by DRG reviewed against National averages
Setup in PPM • Service Code Definition • ICD Diagnosis (Coding Diagnosis) • ICD Procedure (Coding Procedure) • ICD Reference Tables • ICD version • Weight File • DRG Weight – Conditional or Unconditional • Detailed Weight
Create Service Code • Create a new Service Code • Select Coding Procedure as the Service Code Interface • Click … at Service Code Interface • The Maintain Procedure Service Code Interface Values window • Select the Maintain Selections button
Create Service Code • Enter search code at Search String and click Search – Cardiac code • Matching codes display in the list • Tick Create Service Code box and Close • Selected codes will be added to the list • Search again until all the required codes are selected
Create Service Code • Set up the service code definition • Include the Procedure or Diagnosis code in the service code to enable easy identification and use of Detailed Weights.
Let Me Try “I hear and I forget.I see and I remember,I do and I understand.”Chinese Proverb
Exercise – Allied Health • Create new Service Code – Allied Health ICD • Service Code interface – Coding Procedure • Enter search code – 9555 • Select Codes • Social Work – 95550-01 • Physio – 95550-03 • Speech Pathology – 95550-05
Exercise – Allied Health • Set up the service code definition • AlliedHealth- • Code • - • DRG • Include the Procedure or Diagnosis code in the service code and DRG • Check Patient Details.
Example – Organ Retrievals • Costs related to organ retrievals only allocated to those transplant patients • Previously spread across all patients • Service Code used • GL • Dummy Cost Centre • Reclass rule – Penalty rates etc.
Discussion • Other examples • ADHB • Your examples • What other areas? • Continue to try and source patient level utilisation data
Thank You Patrick HoranAuckland District Health Board
