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A1242
October 25, 2005 2:00:00 PM - 4:00:00 PM Hall C4 |
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| Is Coding Anesthesia Care Faster and Easier Using a Personal Digital Assistant or the Manuals? | |||||||||||||||||||||||||
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Jennifer M. Kent, M.D., Jesus A. Rios, M.D., Amr E. Abouleish, M.D., M.B.A. Department of Anesthesiology, University of Texas Medical Branch, Galveston, Texas, United States |
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Introduction: Accurate coding of physician services is necessary for both proper payment of services and avoidance of false claims. The coding process involves conversion of the services to numerical codes based on the diagnosis (ICD-9) and surgical procedure (CPT) (and anesthesia code based on surgical CPT). This coding process can be daunting for physicians, since the manuals used for coding can be thousands of pages long. As a result, many physicians rely on third-party billing companies, a process that leads to a separation in time and location between the service rendered and the service coded and results in an error rate of 5%-19% (1,2). A more accurate method would be for the physician can select the correct ICD and CPT codes at the time of service. With technology development, handheld personal digital assistants (PDA) with coding software are now available for physicians. The purpose of this study is to evaluate the impact of PDA medical coding software on the accuracy and speed of coding anesthesia care by physicians with no experience with coding. Methods: The study design is a randomized crossover study. 10 with no previous experience in coding medical care were randomized to code 10 cases with manuals and 10 cases with PDA-based software. The residents were randomized to either first the PDA (PDA/Man) or manual (Man/PDA). The manuals used were ICD-9-CM (3) and CPT 2005 (4) manuals. The PDA software used was from eComputerized Physican Records (www.ecpr.com, Los Angeles, California). All residents viewed the same slide show presentation introducing the coding process with either method. Each case was limited to 5 min. We measured accuracy of ICD-9 code and surgical CPT code as compared to the codes determined by a certified coder, and the time to complete (average time per case). A poststudy survey on preferences was completed. A Student's two-tailed t-test with a p-value < 0.05 was used to determine significant differences. Results: The average time per case was not different for all cases, but was significantly faster in the PDA group when only correctly coded cases were included. (Table 1) The percentage correct was very similar (76% Man, 72% PDA). Residents found the PDA to be significantly easier to use than Man in coding both ICD-10 and CPT. (Table 2) Discussion: PDAs offer an easier way to code real time without the need for carrying large manuals. In addition, with repetitive use, “most common” codes can be associated with surgeons, thus making coding easier as time progresses. Although not studied, PDA software can be customized to collect additional data (e.g., quality measures, ACGME required data) and prompt the user to complete prior to finishing the actual anesthetic case. References: 1. J Health Care Finance 2003;29(4):29-42. 2. J Health Care Finance 2003;29(4):43-53. 3. International Classification of Diseases, Clinical Modification. 2005. 4. Common Procedural Terminology. 2005.[table1][table2] Anesthesiology 2005; 103: A1242 |
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