New concept: "TARN friendly trauma reporting" (what radiologists say really does matter)

Area of Science:

• Traumatology
• Medical Coding
• Health Informatics

Background:

• Accurate coding of trauma injuries is crucial for patient care and hospital reimbursement.
• The Injury Severity Score (ISS) is a key metric influenced by injury coding.
• Variations in coding practices can affect performance metrics and financial outcomes.

Purpose of the Study:

• To determine if detailed review of trauma reports against coding manuals enhances ISS accuracy.
• To assess the impact of coding changes on hospital performance and tariff payments.

Main Methods:

• Data from 1,693 trauma patients over six months were collected.
• Patients with ISS near tariff boundaries (5-8 and 11-15) underwent radiology review against the ISS coding manual.
• Injuries were re-coded, and ISS was recalculated.

Main Results:

• 169 patients met inclusion criteria; 35 had coding changes, 30 had ISS changes.
• 27 patients' ISS increased, moving them across tariff boundaries, with three crossing two boundaries.
• Re-coding identified potential lost revenue of £15,000 from a single major trauma centre.

Conclusions:

• Referencing ISS descriptions in reporting significantly improves coding accuracy.
• Radiologists adopting standardized, 'Trauma Audit and Research Network friendly' reporting can enhance data accuracy.
• Improved data accuracy positively affects hospital performance and best practice tariff payments.