Maya Agarwala

Title : Assessing the accuracy and quality of activity coding in the orthodontic department

Abstract:

Aims and objectives:

1. To assess the department’s accuracy and quality of clinical coding
2. Identify common coding errors, areas requiring improvement and implement changes to improve orthodontic activity coding
3. Raise awareness of the importance of coding

Methods: A sample of 30 patient’s appointments were randomly selected between January 2023- March 2023 (Cycle 1) and June 2023-August 2023 (Cycle 2) and were reviewed to check accuracy of activity coding. Data collected included: codes selected, actual procedure carried out and codes missing. Data was recorded and analysed on Microsoft Excel.

Results: Cycle 1: 5 appointments were incorrectly coded (16.7%). Of these, 2 (40%) had been incorrectly coded for and 3 (60%) of them failed to include all the procedure codes. For patients whereby all the relevant codes weren’t included, the coder failed to add codes for x-rays (66.7%) as well as clinical photos (33.3%). The incorrect codes were for the procedures of impressions (F14.3 coded but correct code is F15.1) and insertion of orthodontic appliances (F15.5 coded, but F14.3 is correct). Cycle 2: 3 appointments were incorrectly coded (10%). Of these, 2 of them, failed to include all procedure codes. For both appointments X-rays were not coded for. For the other appointment, the incorrect code was inputted (F15.5 coded for a bond up as opposed to F14.1). Accuracy of coding improved overall by 6.7%: 6.7% incorrectly coded and 10% failure to include all codes in cycle 1 vs 3.3%% incorrectly coded and 6.7% failure to include all codes in cycle 2.

Conclusions: Orthodontic activity coding meets the 90% target after cycle 2. Errors in clinical coding are multifactorial and have significant impacts on healthcare resource allocation. It’s important to ensure there is training for all staff, as it impacts not only financial reimbursement rates but also public health planning.

Audience Take Away:

• The importance of clinical coding within the NHS and specifically within the orthodontic department
• Allows for improvements to be made within the service and better patient outcomes

Biography:

Dr Maya Agarwala completed her Bachelor of Dental Surgery degree from King’s College London. She has worked as a dental core trainee in Oral and Maxillofacial Surgery, Oral surgery and restorative departments in London and Leeds. She has a passion for orthodontics and is focused on furthering this through postgraduate training.