BN SO02 - Cholecystectomy HRG Coding Audit

Abstract Background Incorrect coding practices for elective surgical procedures carry significant financial implications at Trust level. In this project, we aimed to audit the current coding practices pertaining to laparoscopic cholecystectomies performed within the NHS WWL Foundation Trust during November 2021-October 2022 and calculate the financial burden resulting from this. Method A list of 194 patients undergoing a cholecystectomy and their allocated HRG coding at time of discharge was compiled by the coding department. A comorbidity and complication index (CCI) for each of these patients was calculated using the operation note together with hospital and GP records. With this information, the correct HRG coding for each patient was calculated and compared to their allocated coding at discharge to calculate the difference in tariffs generated. Results 69.23% of 194 procedures carried out during the reported time period were coded incorrectly. This amounted to a financial burden of £72,232 lost in potential tariffs, equating to £372.33 per cholecystectomy performed. Commonest CCI of 3 in 29% of patients with corresponding HRG code GA10J Commonest incorrectly allocated coding GA10K denotes a presumed CCI of 0 Conclusion High percentage of incorrectly coded procedures with significant financial implications at Trust level Currenty coding practice often incorrectly presumes a CCI index of 0 with subsequent incorrect GA10K coding. However, the appropriate coding for the vast majority of patients undergoing a laparoscopic cholecystectomy was GA10J. Education and awareness is underway to make improvements at a Trust level before re-auditing of data can commence.