title: [Expenditure and reliability of ICD/ICPM-coding in routine surgery].
abstract: Because of the changing legal basis for hospital reimbursement German hospitals have to classify their cases by ICD-9- and an adapted ICPM code (OPS-301) and have to give an advance calculation of the Diagnosis Related Groups (DRG) starting from January 1996. From January 1st 1996 to the 31st of December 1996 all diagnoses and therapies in a general surgery hospital were classified according to ICD-9- and ICPM (OPS-301). This coding was not computer-assisted but was controlled in a multiple step process. As a consequence 4.6% incorrect codes were found which were irrelevant for reimbursement. 7.2% misclassifications relevant for funding were detected with an obvious learning curve within the first 6 months. The calculation of the distribution of diagnoses and therapies reveals that 80 to 85% of the total spectrum in a general surgery hospital (including vascular and thoracic surgery) were covered by 200 diagnostic and therapeutic codes, respectively. This investigation confirms the need for a physician-based control system of diagnostic and therapeutic coding to minimise economic risks.
authors.affiliation: Klinik für Allgemeinchirurgie, Philipps-Universität Marburg. stinner@mailer.uni-marburg.de
authors.forename: B
authors.initials: B
authors.lastname: Stinner
authors.forename: C
authors.initials: C
authors.lastname: Nies
authors.forename: I
authors.initials: I
authors.lastname: Celik
authors.forename: P
authors.initials: P
authors.lastname: Berghöfer
authors.forename: M
authors.initials: M
authors.lastname: Rothmund
mesh_terms: D003953:Diagnosis-Related Groups / Q000592:standards*; D005858:Germany; D006761:Hospitals; D006801:Humans; D012051:Reimbursement Mechanisms; D013514:Surgical Procedures, Operative / Q000145:classification* / Q000191:economics*