Analysis of the Influence of ICD Coding Defects on High-Cost Biased Cases for Disease Grouping based on DIP
Objective To analyze the effect of ICD coding defects on disease grouping of Diagnosis-Intervention Packet(DIP)high-cost biased cases.Methods Data from the home page of medical record and the cost settlement of 342 DIP high-cost biased cases in a tertiary grade A general hospital from 2019 to 2021 were collected.The quali-ty control of ICD codes of DIP high-cost biased cases was performed.After the incorrect ICD codes were cor-rected,the cases were grouped again by DIP.The changes of disease grouping and score before and after the coding correction were analyzed by paired Wilcoxon signed-rank test.Results The defect rate of ICD coding with DIP high-cost biased cases was 19.30％,the defect rate of ICD coding for main diagnosis was 9.36％.The ratio of coding defects of tumor,respiratory system and cardiovascular disease accumulates to 57.53％.The defect rate of coding for operation was 7.93％.Among the 66 cases with ICD coding defects,35 cases with revised codes were regrouped,and the classification and score of DIP disease were changed.The DIP median score increased from 1 022 to 1 089,which was statistically significant(Z=-2.71,P=0.03).Conclusion The DIP high-cost biased cases had a high rate of ICD coding defects.The defect rate of ICD coding in the diagnosis of tumor,respiratory system and circulatory system was prominent.The hospital should make specific measures to improve the quality of ICD coding,provide the key support for the DIP disease grouping,and promote the hospital fine management and high-quality development.
NETL
NSTL
万方数据
