KC60 coding: room for improvement--a study into consistencies and inconsistencies in the use of diagnosing codes

Twenty mock cases were designed. Thirty-two doctors completed the study, assigning local and KC60 codes for service provision and diagnoses. They gave a wide range of responses, often missing codes or adding inappropriate ones. Where the diagnosis was clear, e.g. gonorrhoea, 97% assigned the correct KC60 code. However, the KC60 codes for service provision (S1, S2, P1A, P3, etc.) were frequently omitted, representing a significant underestimate of workload. Some local codes were given by only 6-28% of clinicians, and when they included them, doctors were more likely to omit KC60 codes. Low response rates for local codes renders these codes unhelpful. Simplification of coding procedures is needed so that diagnoses and workload are documented accurately. This is crucial at a time of modernization of genitourinary (GU) Medicine services and the introduction of Payment by Results.