[The Medical Information Systems Project clinical coding and surgeons: why should surgeons code and how?]

The clinical coding system recently instituted in France, the PMSI (Projet de Médicalisation du Système d'Information), has become an unavoidable element in funding allocations for short-term private and public hospitalization centers. Surgeons must take into serious consideration this controversial medicoeconomic instrument. Coding is a dire time-consuming task but, like the hospitalization or surgery report, is an essential part of the discharge procedure. Coding can in the long run be used to establish pricing by pathology. Surgeons should learn the rules and the logic behind this coding system: which, not being based on a medical rationale, may be somewhat difficult to understand. Choosing the right main diagnosis and the comobidity Items is crucial. Quality homogeneous coding is essential if one expects the health authorities to make good use of the system. Our medical societies have a role to play in promoting and harmonizing the coding technique.