Journal article
Hospital Coding of Postoperative Ileus: A Prospective Study
Curēus (Palo Alto, CA), Vol.14(5), pp.e24946-e24946
05/12/2022
DOI: 10.7759/cureus.24946
PMCID: PMC9098212
PMID: 35572461
Abstract
Background
Postoperative ileus (POI) is among the most common complications affecting patients who undergo major abdominal surgery. Because of the high volume of major surgery and the high incidence of postoperative ileus, failure to code for this complication may have a significant impact on hospital reimbursement and quality measures.
Objectives
This paper investigates the magnitude of the difference between the prevalence of POI as coded in administrative data versus the prevalence based upon a prospectively applied operational definition of POI in patients undergoing intestinal resection surgery.
Methods
Data was collected during the course of a prospective study at the University of Iowa Hospitals & Clinics on an investigational digital health device for predicting operationally defined POI. Following the first 24 hours post-surgery, a patient was identified as experiencing POI as operationally defined by the occurrence of vomiting, reversal of diet and/or placement of a nasogastric tube. For all subjects, billing data was also collected.
Results
A total of 203 adult patients undergoing intestinal resection surgery consented to participate. Of patients who developed POI based on the operational definition, 35% were not coded accordingly to capture appropriate risk adjustment and reimbursement.
Conclusions
Patients who experienced indicators of POI but who were not coded experienced over two days of additional time in the hospital compared to patients who did not experience POI, representing significant unreimbursed costs. Timing and duration of POI indicators appear to impact coding discrepancies and may suggest means for improving caregiver identification of POI in a patient’s medical record.
Details
- Title: Subtitle
- Hospital Coding of Postoperative Ileus: A Prospective Study
- Creators
- John W Cromwell - University of IowaLaura W Lund - Gastrointestinal Surgery, University of Iowa Hospitals and Clinics, Iowa City, USA Clinical Research, Clinical Research Strategies, Pittsburgh, USA
- Resource Type
- Journal article
- Publication Details
- Curēus (Palo Alto, CA), Vol.14(5), pp.e24946-e24946
- DOI
- 10.7759/cureus.24946
- PMID
- 35572461
- PMCID
- PMC9098212
- NLM abbreviation
- Cureus
- ISSN
- 2168-8184
- eISSN
- 2168-8184
- Publisher
- Cureus
- Language
- English
- Date published
- 05/12/2022
- Academic Unit
- Surgery
- Record Identifier
- 9984322774202771
Metrics
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