Is coding of diagnoses, comorbidities, and complications in total knee arthroplasty accurate?
Coding of diagnoses, comorbidities, and complications is important for health care delivery, not only for appropriate hospital and physician reimbursement, but also for a correct assessment of complication rates. The purpose of this study was to determine the agreement of coding of diagnoses, comorbidities, and complications for total knee arthroplasty between 2 groups of coders. Between January 1, 1997, and November 18, 1997, 100 consecutive primary total knee arthroplasties were done by 2 orthopaedic surgeons. Diagnoses, comorbidities, and complications were coded by professional hospital coders according to the Healthcare Finance Administration guidelines, then recoded by a second team with orthopaedic experience. Although the hospital coders matched diagnoses with the orthopaedic team 96.5% of the time, they determined a complication rate of 1.4 per patient and a comorbidity rate of 2.9 per patient, whereas the orthopaedic team coded for 0.7 complications per patient and 3.7 comorbidities. Based on these results, there should be interaction and communication between hospital coders and health care professionals to check that coding is accurate and reproducible.
Mont
Michael A
MA
Institute for Advanced Orthopaedics, Sinai Hospital of Baltimore, Maryland 21215, USA. Rhondamont@aol.com
Mears
Simon C
SC
Jones
Lynne C
LC
Rajadhyaksha
Amar D
AD
Krackow
Ann Marie
AM
Bawa
Maneesh
M
Hungerford
David S
DS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000145:classification / Q000706:statistics & numerical data*; D015897:Comorbidity; D003953:Diagnosis-Related Groups; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011183:Postoperative Complications; D015203:Reproducibility of Results; D012189:Retrospective Studies