code it! - ACCD Newsletter Vol 4, No 1, December 2016
Welcome to another edition of our code it! Newsletter.
We would like to take this opportunity to wish you all a Merry Christmas
and a happy, healthy and successful 2017.
The University of Sydney will be closed from Monday 19 December
and will reopen on Tuesday 3 January 2017
What's New in CLIP
New Coding Rules
New Coding Rules have been published in CLIP as at
15 December 2016, for implementation 1 January 2017. Click here to view them.
Updated Coding Rules
The Coding Rule Same-day endoscopy for chronic incurable diseases has been updated for clarity but remains under the original publication date of 15 Jun 2015.
Standards for ethical conduct in clinical coding
The code of ethics for clinical coders has been in the Appendices of the Australian Coding Standards (ACS) since its inception (July 1998). An update occurred for second edition (2000), however since that time the document has remained unchanged. Please refer to the section below for an updated version of the standards for ethical conduct in clinical coding to be published in Tenth Edition of the ACS.
HIMAA New Certificate Course
As a Registered Training Organisation, the Health Information Management Association of Australia (HIMAA)* is now offering a full VET-level qualification in clinical coding, the 22274VIC Certificate IV in Clinical Classification. Further information is available at this link.
Purchase of Products
Please refer to the Ordering section below.
Back to top
Since our last update in September 2016, ACCD has delivered the Tenth Edition Electronic Code Lists (ECLs) and maps to the Independent Hospital Pricing Authority (IHPA) in preparation for their release; with ICD-10-AM/ACHI/ACS Tenth Edition approved by the Pricing Authority (PA) at the end of November. We are now concentrating our efforts towards desktop publishing and proofing of the Tenth Edition in preparation for a print ready version to be delivered to IHPA at the end of January.
Progress on the development of online education as noted below under Education (including a Reference to Changes Document) is also well underway. In addition, we are preparing to update the Fundamentals of Morbidity Coding for release in the first half of 2017.
The Chronicle (a document of changes between all editions of ICD-10-AM/ACHI/ACS) is also in the process of being updated and we are currently investigating options to make it available as a web-based product to replace the current linked PDF version. The Chronicle is due to be delivered 1 July 2017 in conjunction with the release of Tenth Edition.
A summary forecast of Tenth Edition will be published in the March 2017 code it! Newsletter.
Back to top
AR-DRG Version 9.0 Development
Following the finalisation of the revisions for AR-DRG Version 9.0, the last stage of development is the splitting of the Adjacent Diagnosis Related Groups (ADRGs) into Diagnosis Related Groups (DRGs) or end classes. This determines the number of ADRGs that have one DRG only (Z) or are split into two, three or four DRGs (A,B,C,D).
Splitting criteria are applied to produce various splitting models for comparison. The preferred model is selected based on statistical performance, clinical coherence and other special factors that have applied in previous AR-DRG versions. In consultation with the DRG Technical Group (DTG) the final splits were determined for each ADRG, with the 'optimal' model being selected for the large majority of ADRGs (where the minimum thresholds applied to each criterion are satisfied).
The final report for Version 9.0 has now been submitted to IHPA for approval by the Pricing Authority. ACCD is currently working on the production of the print ready version of the Definitions Manual and the grouper specifications, scheduled for delivery to IHPA by 31 January 2017.
AR-DRG Version 8.0
AR-DRG Version 8.0 has now been implemented in public hospitals for nearly six months. An education tutorial outlining the changes in Version 8.0, including the Episode Clinical Complexity (ECC) Model, continues to be available on the ACCD website. Further details are available in the Education section on the ACCD website.
Errata 1 (February 2016) for the AR-DRG Version 8.0 Definitions Manual is available for download (print errors in Volume 1 only). Click here to download the errata.
Back to top
At the recent HIMAA/NCCH 2016 Conference, NCCH presented a session on the Conventions which underpin the classification structure. This presentation can be downloaded from the ACCD website.
Development of the Tenth Edition online education is underway and will become available in May 2017.
Meanwhile, the material from both the ICD-10-AM/ACHI/ACS Ninth Edition online education and the Ninth Edition FAQs Coding workshop presented at the HIMAA/NCCH Conference 2015 continue to be available in the Education section of the ACCD website.
A presentation on the development of AR-DRG Version 9.0 was also given at the recent HIMAA/NCCH Conference, and is available for download. This version is scheduled for release in July 2017, and online education will again be provided by ACCD.
Education for AR-DRG Version 8.0 continues to be available on the ACCD website as a tutorial video (with presentation slides as an accompanying downloadable PDF). Users of the classification are encouraged to undertake this tutorial to ensure they have an understanding of the changes in the case complexity methodology with the implementation of the Episode Clinical Complexity (ECC) Model in Version 8.0.
Back to top
Standards for Ethical Conduct in Clinical Coding
The Code of Ethics for Clinical Coders has been in the Appendices of the Australian Coding Standards since its inception (July 1998). An update occurred for second edition (2000), however since that time the document has remained as is. The ICD Technical Group (ITG) discussions across the December 2015 and March 2016 meetings, suggested that ACCD undertake a revision of the code of ethics in line with changes within the industry. This update was not because it was thought that clinical coders were doing the wrong thing, but because feedback was indicating that clinical coders need a more detailed document to protect them if they are asked to do something that could seem unethical during the coding process.
ACCD undertook a revision of the existing code of ethics, with consideration of other professional body’s code of ethics/professional codes of conduct within Australia and internationally (including the Health Information Management Association of Australia (HIMAA), the Clinical Coders Society of Australia (CCSA), Canada, United States of America, and the United Kingdom).
ACCD considered issues such as:
- What information is required in a code of ethics in today’s coding setting?
- What is impacting on clinical coding in the current environment?
- Why do we have a code of ethics?
- What ethical issues are impacting upon the clinical coding workforce?
- Are clinical coders being pressured to write unethical clinician queries?
The draft document was shared with ITG members (that included representatives from HIMAA and CCSA) for comment, and a final document was produced.
The new Standards for Ethical Conduct in Clinical Coding has three components:
- Ethics in Clinical Coding Practice
- Ethics in Clinical Coding Quality and Education
- Ethics in Clinical Coding and Legal Requirements
Ethics in Clinical Coding Practice details the ethics that should be upheld in day to day coding, including clinician queries.
Ethics in Clinical Coding Quality and Education details clinical coder participation in activities to improve coding practice within the work environment, and developing the profession.
Ethics in Clinical Coding and Legal Requirements details legal ethics, however it does not replace any legal requirement placed on clinical coders (i.e. Privacy Act).
To download the document and for further information, please visit this link:
Back to top
Report on PCSI Conference 2016
The 32nd Patient Classification Systems International (PCSI) Conference was held in Dublin, Ireland from 4-7 October 2016. PCSI is the only international organisation addressing casemix issues, and the annual conference provides a valuable opportunity to discuss issues related to casemix classifications and share the experiences and approaches being taken worldwide. Ireland is currently in the process of implementing Activity Based Funding (ABF), and is one of many countries around the world that use our AR-DRG Classification System.
The theme of this year's conference was 'Towards Activity Based Management: Putting the Patient at the Centre', and explored the ways in which ABF is applied for managing hospitals and healthcare systems, and also the issues surrounding the building blocks of ABF. Sessions included casemix funding and payment systems, costing health care activities and casemix applications, quality of care and patient outcomes, integrated care models, health services planning and clinical management using casemix, and coding and clinical classifications. Delegates from a diverse range of countries gave presentations, including Germany, the UK, Canada, the Netherlands, Indonesia, France, Norway, Sweden and Korea. ACCD presented a paper titled 'A Structural Review of the AR-DRG classification - moving towards Version 9.0' which outlined the development work currently being undertaken on the Australian classification. Other casemix and classification developments in Australia were also presented, including a keynote address by James Downie, the CEO of IHPA.
Against the fabulous historical backdrop of Dublin city, many innovative approaches to the development and application of casemix classifications were shared, contributing to the ongoing improvement of casemix classifications worldwide.
The 33rd annual Patient Classification Systems International (PCSI) Conference will be held in Sydney, Australia from the 9th to the 13th October 2017.
Back to top
The 2016 Health Information Management Association of Australia (HIMAA) and National Centre for Classification in Health (NCCH) National Conference report.
This year’s national HIMAA/NCCH Conference was very successful, with over 400 participants, participating and listening to high quality health information and clinical coding presentations and workshops.
The opening keynote was delivered by Deborah Green from the American Health Information Management Association on Information Governance for Healthcare who told us of the emerging super discipline of information governance and the need for consumer friendly health information. Dr Philip Hoyle, from Royal North Shore Hospital in Sydney and Principal Clinical Adviser for the NCCH, was our second keynote speaker. Philip presented a clinician’s view on ‘health information for a changing world’ and highlighted the threats and opportunities that health information professionals should be aware of in order to raise their profile and maintain their relevance as health care moves into a digitised age. He made a very powerful statement which set the tone for the three day conference.
“The health information profession has a unique practical and ethical impact, but to prosper it must continue, in the public interest, to drive the deployment of information and its ethical use.”
The coding and classification stream of the conference had Professor Richard Madden from the NCCH present on new opportunities for using functioning properties (included in ICD-11) within ABF systems in the future. Jill Burgoyne from the Northern Territory summed up the importance of coding practice as “the beating heart of health information” and presentations on coding projects and ethical coding practice challenged us and facilitated further discussions during our networking events.
Our Coding and Classification Workshops were well received and provided clinical updates on spinal injuries, and clot retrieval using neuroradiological interventions. A ‘Back to Basics’ coding workshop and a preview into developments for the Tenth Edition of ICD-10-AM/ACHI/ACS refreshed our fundamental knowledge in coding and provided insight into what to expect on 1 July 2017 when Tenth Edition will be implemented for Australian coding practice, nationally.
Activity-based Funding (ABF) formed another key theme that was initiated this year by a keynote and workshop, presented by John Pilla from NCCH consortium partner, KPMG, on the view of ABF from the operational side. Carol Loggie from the NCCH also updated the conference on the impending changes in the Australian Refined Diagnosis Related Groups (AR-DRG) for Version 9.0. The final day plenary provided the conference with some outstanding information presented by James Downie from IHPA who spoke on proposals to incorporate safety and quality into pricing and funding of public hospital services. Vera Dimitropoulos then introduced some important concepts within the world according to Activity Based “practice” where ABF, Activity Based Management (ABM) and other processes can be used in conjunction to improve the use of linked data in an integrated health care environment. We were also delighted to welcome Marie Glynn and Jacqui Curley from the Irish Healthcare Pricing Office to deliver a great session on the bridge between Ireland and Australia in ICD-10-AM/ACHI/ACS and how that bridge has been joined.
The final plenary session saw representatives from each of the Australian jurisdictions discuss progress on implementing ABF/ABM during a panel session showcasing the great work being undertaken nationally in this space.
HIMAA and the NCCH partner each year to provide our professional HIMs and Clinical Coders with the best professional development we can deliver. Please join us next year when we will be in Cairns, Queensland at the Pullman Cairns International from 1 to 4 November 2017.
The 2016 HIMAA NCCH Conference proceedings are available from this link:
Back to top
IHPA ABF and PCSI (Patient Classification Systems International) Conference 2017
Sydney, 9-13 October 2017
Watch this space
HIMAA NCCH Conference 2017
Cairns, 1-3 November 2017
Pullmann Cairns International
Watch this space
For further professional development opportunities and ongoing education please refer to:
https://www.accd.net.au/ (What’s New)
Back to top
Ordering ICD-10-AM/ACHI/ACS and AR-DRG Related Products
The Ninth Edition ICD-10-AM/ACHI/ACS hard copy books, Electronic Code Lists (ECLs), Mapping Tables and AR-DRG Version 8.0 Definitions Manual
available for purchase from the IHPA Sales website.
Please also refer to the IHPA AR-DRG Classification System Product Sales Frequently Asked Questions Sales website.
Fundamentals of Morbidity Coding
The NCCH has released a Ninth Edition revision of the Fundamentals of Morbidity Coding. This book provides a useful reference for clinical coder trainees or those returning to the coding work force who wish to re-familiarise themselves with coding basics and is now available for purchase.
ICPC-2 PLUS License
If you are developing a software program, either for clinical or research
purposes, and would like to consider using the ICPC-2 PLUS terminology, see the
section of the NCCH website.
Back to top
If you are purchasing an EHR system that
incorporates ICPC-2 PLUS and would like to use it for coding your health
information, see the End Users section
of the NCCH website