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Briefing: Coding Audit Results

Briefing: Coding Audit Results. Date: March 31 Time: 1010 – 1200. Objectives. Review the Results of the Coding Audit of FY2006 Records, including: Response Rates Percent Passing the Audit Number of Errors Encountered Types of Coding Errors Lessons Learned from the Audit

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Briefing: Coding Audit Results

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  1. Briefing: Coding Audit Results Date: March 31 Time: 1010 – 1200

  2. Objectives • Review the Results of the Coding Audit of FY2006 Records, including: • Response Rates • Percent Passing the Audit • Number of Errors Encountered • Types of Coding Errors • Lessons Learned from the Audit • Suggestions for Improvement

  3. Audit Goals ● Produce Service level estimates of the coding accuracy of Inpatient, Outpatient, and APV records during FY 2006 ● Provide feedback to MTFs to enable them to improve their medical coding ● Comply with DoD Directive 6040.41 of April 13, 2004 and DoD Instruction 6040.42 of June 10, 2004 ● Validate MHS costs of providing health care to Medicare-Eligible retirees at MTFs during FY 2006, (Medicare-Eligible Retiree Health Care Fund (MERHCF)).

  4. Audit Methods • Audit Samples • 11 random samples of FY 2006 medical records drawn from across the direct care system • Total audit size = 7100; SADRS from 276 MTFs; SIDRs from 64 MTFs

  5. Outpatient Results

  6. Our goal was an 85% response rate

  7. The Most Common E&M Errors in Records that Failed the Audit * None of the services had more than 1% of failed APV records with any E&M error.

  8. The Most Common Diagnosis Errors in Records that Failed the Audit

  9. Inpatient Results

  10. “Failed’ Criteria is not limited to incorrect DRG

  11. “Failed’ Criteria is not limited to incorrect DRG

  12. Quality Assurance • Percent Agreement Inter-examiner Reliability (Agreement between the Study Auditor and a Reference Auditor) Agreement • SIDR 93.42% • SADR 96.35% • Percent Agreement for Intra-examiner Reliability • (Agreement between the Study Auditor and themselves) • Agreement • SIDR 96.49% • SADR 97.65%

  13. Summary • Reviewed the Results of the Coding Audit of FY2006 Records, including: • Response Rates • Percent Passing the Audit • Number of Errors Encountered • Types of Coding Errors • Lessons Learned from the Audit • Suggestions for Improvement

  14. Speaker Information <Redacted>

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