Shortfalls in malnutrition coding: A mandate for actionThe Dietitians Association of Australia 30th National Conference (2013)
The International Classification of Diseases, Version 10, Australian modification (ICD-10-AM) is commonly used to classify diseases in hospital patients. ICD-10-AM defines malnutrition as “BMI <18.5 kg/m2or unintentional weight loss of ⱖ 5% with evidence of suboptimal intake resulting in subcutaneous fat loss and/or muscle wasting”. The Australasian Nutrition Care Day Survey (ANCDS) is the most comprehensive survey to evaluate malnutrition prevalence in acute care patients from Australian and New Zealand hospitals1. This study determined if malnourished participants were assigned malnutrition-related codes asper ICD-10-AM. The ANCDS recruited acute care patients from 56hospitals. Hospital-based dietitians evaluated participants’ nutritional status using BMI and Subjective Global Assessment (SGA). In keeping with the ICD-10-AM definition, malnutrition was defined as BMI<18.5 kg/m2, SGA-B (moderately malnourished) or SGA-C (severely malnourished). After three months, in this prospective cohort study, hospitals’ health information/medical records department provided coding results for malnourished participants. Although malnutrition was prevalent in 32% (n = 993) of the cohort (N = 3122), a significantly small number were coded for malnutrition (n = 162, 16%, p < 0.001).In 21 hospitals, none of the malnourished participants were coded. Thesis the largest study to provide a snapshot of malnutrition-coding in Australian and New Zealand hospitals. Findings highlight gaps in mal-nutrition documentation and/or subsequent coding, which could potentially result in significant loss of case mix-related revenue for hospitals. Dietitians must lead the way in developing structured processes for malnutrition identification, documentation and coding.
Publication DateMay, 2013
Citation InformationEkta Agarwal, Maree Ferguson, Merrilyn Banks, Judith Bauer, et al.. "Shortfalls in malnutrition coding: A mandate for action" The Dietitians Association of Australia 30th National Conference (2013)
Available at: http://works.bepress.com/ekta-agarwal/11/