Page 239 - DCAP305_PRINCIPLES_OF_SOFTWARE_ENGINEERING

Unit 11: Coding Process

• The software had difficulty distinguishing between status codes and follow-up codes Notes
(V-codes).
• For obstetric codes or other code sections in which the 5th digit needed to be determined
as a distinct thought process, the software selected code with an ‘x’ for the 5th digit or
reported back a range of codes.
• The software had difficulty distinguishing between poisonings and adverse drug events,
although even human coders have trouble with this. There was no E code (External
Cause of Injury Code) selection by the software.

• The software had a problem selecting E codes for accidents. No ‘Place of Occurrence’
E Codes were assigned.
• The determination of ‘history of’ conditions versus ‘active’ conditions also proved
problematic for the software.
• The software had difficulty in determining context of ‘cervical’—neck versus cervix. It
coded Cervical Spine Exam to Examination of cervix.
• There were some misses on code assignment—chronic lower leg edema was coded to
unequal leg length.
• Chest pain with radiation was coded as chest pain with radiotherapy.

• Some procedures were not coded at all (such as biventricular pacemaker).
• Some grouping issues were noted (certain principal diagnosis codes would not group
to the correct DRG).
• The system did not allow for disposition code effect on DRG. It assumed all discharges
were to be assigned to the status of ‘home.’
• The system defaulted birth defects to ‘congenital’ codes.
• The software missed the code for the specific organisms for many infections.

• The software had difficulty dealing with some acronyms and abbreviations or
distinguishing an abbreviation from letters imbedded in a word—for example, CAD
(academic).
• The software had great difficulty dealing with procedures with multiple components
(which parts to bundle and which to code separately).
2. Ease of Use

The software was very intuitive. It required minimal training (less than one/half day) and
the coders liked using it.

The software had no problems importing the transcribed documents. No data manipulation
required.

3. Enhanced Coder Productivity
Productivity was not enhanced due to the coder needing to research each of the numerous
codes returned by the program (average of 20 codes per case). Coder A reported coding two
and a half charts per hour. Coder B reported coding four charts per hour. Our productivity
range for inpatient is three to five charts coded per hour. Clearly, this software did not
enhance productivity.
Contd...

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