BACKGROUND Artificially influencing the case mix of hospitals may have several deleterious consequences for the hospital care system. One distinguishes over-evaluation (up-coding) and under-evaluation (under-coding) of the case mix. Apart from its financial consequences, miscoding may cause a fracture in epidemiological time series and, by increasing artificially the severity of illness, may af...

IS IT EVER ETHICAL FOR A PHYSICIAN TO CODE A PATIENT’S DIAGNOSIS falsely inamedicalrecordtogainbenefits forthepatient?Thesmallamount of empirical research available suggests that many physicians do indeed choose to deceive third-party payers. In a decade-old survey, 70% of a sample of clinicians stated that hypothetically, they would write “rule outcancer” tosecure funding for screeningmammogra...

OBJECTIVES The study aimed to find out any inaccuracy in coding of elective urology procedures and associated financial implications. DESIGN Retrospective audit and re-audit. SETTINGS Introduction of payment by results was introduced in the NHS in England in 2002. This meant that hospitals are paid on individual patient basis according to their human resource group (HRG) rather than a block...

BACKGROUND This article reviews the literature to date and reports on a new study that documented the frequency of manual code-requiring blood glucose (BG) meters that were miscoded at the time of the patient's initial appointment in a hospital-based outpatient diabetes education program. METHOD Between January 1 and May 31, 2007, the type of BG meter and the accuracy of the patient's meter c...