1. Filling Feeder Gaps using ICD codes 2008 PPM User Conference Philip Moore

2. Slide 2 PowerHealth Solutions 2008 PPM User Conference Agenda 1.Overview 2.Auckland example – Implants 3.Method in PPM 4.Exercise – Allied Health 5.Discussion – other areas

3. Slide 3 PowerHealth Solutions 2008 PPM User Conference Overview What are feeder gaps? Why use ICD service codes vs DRG only How set them up

4. Slide 4 PowerHealth Solutions 2008 PPM User Conference ADHB - Implants No patient level data available Obtained data from another DHB with patient level implant data Adjusted for local practice Cost by DRG reviewed against National averages

5. Slide 5 PowerHealth Solutions 2008 PPM User Conference Setup in PPM Service Code Definition ICD Diagnosis (Coding Diagnosis) ICD Procedure (Coding Procedure) ICD Reference Tables ICD version Weight File DRG Weight – Conditional or Unconditional Detailed Weight

6. Slide 6 PowerHealth Solutions 2008 PPM User Conference Create Service Code 1.Create a new Service Code 2.Select Coding Procedure as the Service Code Interface 3.Click … at Service Code Interface 4.The Maintain Procedure Service Code Interface Values window 5.Select the Maintain Selections button

7. Slide 7 PowerHealth Solutions 2008 PPM User Conference Create Service Code 6.Enter search code at Search String and click Search – Cardiac code 7.Matching codes display in the list 8.Tick Create Service Code box and Close 9.Selected codes will be added to the list 10.Search again until all the required codes are selected

8. Slide 8 PowerHealth Solutions 2008 PPM User Conference Create Service Code 11.Set up the service code definition 12.Include the Procedure or Diagnosis code in the service code to enable easy identification and use of Detailed Weights.

9. Slide 9 PowerHealth Solutions 2008 PPM User Conference Let Me Try I hear and I forget. I see and I remember, I do and I understand. Chinese Proverb

10. Slide 10 PowerHealth Solutions 2008 PPM User Conference Exercise – Allied Health 1.Create new Service Code – Allied Health ICD 2.Service Code interface – Coding Procedure 3.Enter search code – 9555 4.Select Codes Social Work – 95550-01 Physio – 95550-03 Speech Pathology – 95550-05

11. Slide 11 PowerHealth Solutions 2008 PPM User Conference Exercise – Allied Health 5.Set up the service code definition AlliedHealth-Code-DRG 6.Include the Procedure or Diagnosis code in the service code and DRG 7.Check Patient Details.

12. Slide 12 PowerHealth Solutions 2008 PPM User Conference Example – Organ Retrievals Costs related to organ retrievals only allocated to those transplant patients Previously spread across all patients Service Code used GL Dummy Cost Centre Reclass rule – Penalty rates etc.

13. Slide 13 PowerHealth Solutions 2008 PPM User Conference Discussion Other examples ADHB Your examples What other areas? Continue to try and source patient level utilisation data

14. Slide 14 PowerHealth Solutions 2008 PPM User Conference Thank You Patrick Horan Auckland District Health Board