International Journal of Community Medicine and Public Health | November 2019 | Vol 6 | Issue 11 Page 1
International Journal of Community Medicine and Public Health
Oashttamadea R. Int J Community Med Public Health. 2019 Nov;6(11):xxx-xxx
http://www.ijcmph.com
pISSN 2394-6032 | eISSN 2394-6040
Original Research Article
Effects of training on coding accuracy of obstetrical
diagnosis in Naili DBS Hospital
Ressa Oashttamadea*
INTRODUCTION
Health financing is fundamental to the ability of health
systems to maintain and improve human welfare. At the
extreme, without the necessary funds no health workers
would be employed, no medicines would be available and
no health promotion or prevention would take place.
1
Hospital medical billing is the process of submitting and
following up on claims to insurance companies in order to
receive payment for services rendered by hospitals. The
hospital billing process begins when a patient arrives to
the hospital for diagnosis and treatment of an injury,
illness, disease, or condition. Until the patient‟s departure,
all of the services and items provided are recorded to
patient‟s account. In the next step, all infor mation and
charges are processed for billing based on the
requirements of insurance companies, which generally
have reimbursement rules. During the billing process, if a
hospital does not meet the requirements of an insurance
company, stoppages to hospital payments and fines to the
hospitals are generally charged.
2
Accurate billing is crucial for the financial health of
medical institutions. Billing and coding are based on what
services are documented by the provider and selection of
the appropriate code is most commonly done by the
provider or a coding specialist.
3
Medical coding is the
transformation of healthcare diagnosis, procedures,
medical services, and equipment into universal medical
alphanumeric codes. It can be subsequently used for
ABSTRACT
Background: The accuracy of clinical coding is very important in the proper financing of health care centers. During
January to February 2019, only 35 out of 60 obstetrical cases that were well coded (58%) in Naili DBS Hospital and
this miscoding would led to a big financial loss. The aim of this study is to determine the effect of training on coding
accuracy.
Methods: This study was conducted during April 2019 in Naili DBS Hospital using quasi experimental method, with
one group pretest and post-test design. All 11 participants were given a pretest consisted of 10 long cases (maximum
score=38) and the training was conducted based on the identified needs from the preliminary audit. They were then
given a post-test to see the effect of the training.
Results: The mean score of pretest was 10.7 and the mean score of post-test was 19.7. The individual scores were
normalized and then analyzed using SPSS with paired sample T-test. Based on statistical analysis, p<0.005 meaning
the traning is statistically significant on improving the coding accuracy in obstetrical diagnosis.
Conclusions: The training has significantly improved the score of well coded obstetrical diagnosis, even though the
participants have not reached the maximum score. Furthermore, our study suggests that it is important to analyze the
coders‟ performance months after the training by conducting a coding audit.
Keywords: Coding accuracy, Miscoding, Training, Obstetrical, ICD 10
Department of Medical Record and Health Information Management, Apikes Iris, Padang, Indonesia
Received: 12 September 2019
Accepted: 11 October 2019
*Correspondence:
Dr. Ressa Oashttamadea,
E-mail: oashttamadea@yahoo.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20194631