以内镜治疗编码为例分析病案首页质量对医保支付的影响

doi:10.3969/j.issn.1006-5253.2022.03.007

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Abstract Objective To study the effect of the quality of the first page of medical records on the enrollment of medicare of DRGs.Methods With the operation code of endoscopic treatment as an example, the data of 740 patients who underwent gastrointestinal endoscopic treatment in a hospital from January 1 to December 31, 2020 were collected. The first page of medical records was checked and revised to compare the inclusion of medicare of DRG before and after the revision, and the chi-square test was used to compare the difference in medical insurance payment before and after the revision.Results Fifty-five out of 740 medical records were wrong in coding, with an error rate of 7.39%. After the revision, the average number of points paid by medicare payments increased from 75.56 to 77.47. There was statistically significant difference in DRG before and after the revision (χ²=2 013.04, P<0.05).Conclusion In the cases of endoscopic treatment of digestive tract lesions, the influence of main operation code selection errors on DRG is bigger than the influence of main diagnostic errors, and coding errors could affect the inclusion of medicare payments of DRG and the amount of medicare payments. Improving the coding quality of the first page of medical records for the medical behavior to be objectively and truly expressed, is helpful for the accurate operation of medicare payment reform.

Key words： diagnosis related group (DRG) medicare payment therapeutic endoscopy operation code

Received: 29 February 2020

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	Articles by authors
	Wu Youmei
	Miao Yanyao
	Xü Meijun
	Yuan Boying

Cite this article:

Wu Youmei,Miao Yanyao,Xü Meijun, et al. Effect of the quality of the first page medical records on medicare payment by taking endoscopic therapy code as an example[J]. journal1, 2022, 29(3): 192-195.

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http://manu58.magtech.com.cn/Jwk_zgyytj/EN/10.3969/j.issn.1006-5253.2022.03.007 OR http://manu58.magtech.com.cn/Jwk_zgyytj/EN/Y2022/V29/I3/192

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