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Coding Accuracy for Outpatient Ophthalmic Surgery: St. Joseph's Healthcare Hamilton
1Staff ophthalmologist at St. Joseph's Healthcare Hamilton (SJHH), Department of Eye Medicine and Surgery. She has held various clinical and academic administrative leadership positions over the years and is currently executive member of the SJHH Medical Staff Association. An associate clinical professor and past residency program director in McMaster University's Division of Ophthalmology, Dr. Ahuja is a high-volume cataract surgeon actively involved in residency education.
Abstract:
Coding accuracy is an important factor in ensuring hospitals receive adequate reimbursement from the government for healthcare services rendered. A retrospective review of 100 charts, the purpose of this study was to determine the degree of coding accuracy from the surgeon perspective, for outpatient procedures performed for ophthalmic services at St. Joseph's Healthcare Hamilton from July to December 2016. Using ICD-10-CA, Canadian Classification of Health Interventions, Quality-Based Procedures criteria where applicable, and the 3M Coding and Reimbursement system, this paper reveals three primary sources of coding errors and presents recommendations to increase accuracy of reimbursement for the benefit of both the Ministry of Health and hospital organizations.