The effect of template-based sequential (TBS) coding on an NHS plastic surgical practice

Area of Science:

• Medical Coding
• Plastic Surgery
• Healthcare Finance

Background:

• Clinical coding accuracy is vital for financial sustainability in plastic surgery.
• Rapid advancements in surgical procedures challenge accurate coding by non-physicians.
• A discrepancy exists between surgical complexity and current coding practices.

Purpose of the Study:

• To evaluate the impact of surgeon involvement in clinical coding on practice revenue.
• To compare the financial outcomes of traditional coding versus surgeon-assisted coding.
• To identify methods for improving coding accuracy and financial performance in plastic surgery.

Main Methods:

• A prospective audit analyzed 2586 patients over six months.
• Phase I: Coding by clinical coders based on operating notes.
• Phase II: Surgeons completed OPCS 4.7 codes, with clinical coder vetting.

Main Results:

• Procedural income per case increased significantly: 49% for general plastic surgery and 58% for facial palsy.
• Outpatient income rose by 3% (facial palsy) and 6% (general plastic surgery).
• Improved coding provided greater insight into procedure tariffs.

Conclusions:

• Surgeon-led coding, supported by clinical coders, enhances data capture and increases revenue.
• Implementing proforma-based operating notes for common procedures is recommended.
• This collaborative approach optimizes financial sustainability in plastic surgery practices.