Help is at hand for independent healthcare providers so they can meet the Competition & Markets Authority’s (CMA)1 demand for high quality performance data to guide patients and their doctors. The latest Clinical Coding Toolkit from Healthcode, the experts in online solutions for the private health sector, will support the use of ICD-10 and OPCS-4 coding systems, ensuring Quality and Outcomes information is comparable with the NHS, without compromising the billing process for insured patients.
Peter Connor, Managing Director of Healthcode said: “The private healthcare sector has reached a watershed moment. The CMA’s call for providers to assist effective patient choice by publishing robust Quality and Outcomes information, means that we risk undermining the excellent care available if we do not record the necessary clinical data.
“As Healthcode has pointed out in our two recent white papers2 on this important subject, clinical coding has historically only been seen by independent providers as part of the billing process and the sector has been held back by an antiquated set of diagnosis codes known as ICD-9. This started to change as private sector hospitals began treating NHS patients and treatment had to be coded in line with NHS systems but now we have an even more pressing reason to adopt recognised coding standards.
“Healthcode’s Clinical Coding Toolkit supports the implementation of effective coding, even for providers with limited in-house coding resources. Users can quickly zero-in on the relevant codes for recording a patient’s diagnosis or treatment, making the whole process faster, more intuitive and avoiding the need to send clinical records to coding teams which can delay the billing process for insured patients.”
Using the latest version of the Toolkit, providers will be able to look up the different diagnosis and procedure codes used in the NHS and independent sector using an intuitive plain language terminology search, a body map or clinical description. For example, users can search for the common term ‘glue ear’, rather than the clinical code description ‘otitis media with effusion (OME)’.
The Toolkit also features cross-classification code mappings between OPCS-4 and CCSD or ICD-10 and ICD-9 and vice versa. This eliminates the need to maintain and use multiple coding systems for recording clinical activity and billing purposes. Healthcode’s code mapping technology is already being used by the Private Hospital Information Network (PHIN) to convert hospital episodes recorded using the CCSD codes into OPCS so its published quality indicators are comparable with the NHS.
The Clinical Coding Toolkit is available from Healthcode on a subscription basis. Advice and support is available from Healthcode’s business development team.
1Paragraph 11.571,Private Healthcare Market investigation, Competition and Markets Authority, April 2014
2 A comparison of CCSD and OPCS procedure classifications and an assessment of mapping challenges, Healthcode, April 2014 and The path to the adoption of ICD-10 diagnosis coding for the independent sector, Healthcode, May 2014. Both white papers were published as inserts in Independent Practitioner Today (May and June issues) and are available on the Healthcode website.