Performance Indicators for Coding Quality (PICQ) 2008



 

A powerful ICD-10-AM/ACHI code analysis tool to monitor, measure and evaluate coding quality and to facilitate improvement in coding quality

The NCCH is pleased to announce the release of PICQ 2008, a powerful ICD-10-AM/ACHI code analysis tool to monitor, measure and evaluate coding quality and to facilitate improvement in coding quality

What is PICQ?

PICQ is a series of indicators which analyse admitted patient morbidity data coded with ICD-10-AM and the Australian Classification of Health Interventions (ACHI) and is based on Australian Coding Standards (ACS) and coding conventions. Users link their coded data to the PICQ database and the records are then compared to the predetermined indicators that test coding quality. The indicators identify records that contain a coding error (or possible coding error) in diagnosis and procedure codes or a National Health Data Dictionary (NHDD) field, such as age. The indicators are categorised according to the type of problem the indicator seeks to identify.

What does PICQ do?

PICQ indicators analyse disease and procedure codes:

  • in combination with other codes and/or
  • in combination with NHDD data items
  • and/or in a sequence and/or
  • for their presence or absence and/or
  • for their specificity

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Examples of PICQ indicators (in narrative terms):

PICQ indicators are categorised according to the type of problem the indicator seeks to identify. Following are some examples of indicators according to indicator type:

Edit problem
Indicator 100367 External cause code as principal diagnosis identifies records with an external cause code as principal diagnosis. ACS 2001 External cause code use and sequencing states that external cause codes must never be the principal diagnosis: the principal diagnosis is the injury, poisoning, and so forth.

Completeness problem
Indicator 100331 Type of spinal cord lesion code without functional level of spinal cord lesion code identifies records containing a type of spinal cord lesion code but no functional level of lesion code. ACS 1915 Spinal (cord) injury states that a spinal cord injury, in the initial stage post trauma, should be coded in this sequence: type of cord lesion (complete/incomplete), functional level of spinal cord lesion, and, if appropriate, vertebral injury (fracture, dislocation).

Redundancy problem
Indicator 101401 Harmful use of tobacco code with specific related disorder code identifies records containing both a harmful use of tobacco code and a specific tobacco related disorder code. ACS 0503 Drug and alcohol use disorders states that, ?harmful use? of a substance cannot be coded if a specific related disorder is present for that substance. The harmful use is implicit in these other conditions.

Specificity problem
Indicator 101986 Oesophageal varices code with underling cause code identifies records containing an oesophageal varices code and a specific underlying cause code, but not a manifestation/aetiology code combination. Oesophageal varices in or due to alcoholic liver disease, toxic liver disease, cirrhosis of the liver or schistosomiasis should be assigned an aetiology (dagger)/manifestation (asterisk) code combination as instructed in the Alphabetic Index of Diseases, rather than unrelated codes for the two conditions.

Sequencing problem
Indicator 100191 Gastritis code as principal diagnosis followed by gastric ulcer code identifies records with gastritis as principal diagnosis followed by a gastric ulcer code. ACS 1106 Gastric ulcer with gastritis states that, where both gastric ulcer and gastritis are present, the gastric ulcer code should be sequenced before the gastritis code.

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10 good reasons to use PICQ

  • identify actual coding errors and possible coding problems
  • identify specific records for correction, if necessary
  • suggest possible problem causes
  • suggest possible corrections
  • measure data accuracy against particular indicators
  • measure data quality over time
  • provide continuous review and amendment of coded data
  • provide feedback to individual coders and assist coder education
  • benchmark results with similar hospital or health organisation
  • complement existing coding audit activities

Who would benefit from using PICQ?

PICQ is a valuable addition to the coding and data quality initiatives conducted by a wide cross-section of people in the health industry including:

  • clinical coders
  • health information managers
  • casemix analysts
  • data managers
  • coder educators
  • researchers
  • clinicians
  • health administrator or managers
  • health department officials, especially those in policy and planning
  • private health insurers

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The PICQ 2008 CD-ROM package

The PICQ 2008 CD-ROM package includes:

  • two Microsoft Access® databases (Access2000® and Access2003®) for ICD-10-AM/ACHI/ACS First, Second, Third, Fourth and ICD-10-AM/ACHI/ACS Fifth Editions
  • step-by-step installation directions
  • comprehensive instructions on how to use PICQ
  • a sample casemix database containing a limited number of patient episodes to allow users to become familiar with the program before linking their own data
  • a readme.txt file that contains notes on system requirements and installation of PICQ
  • PICQ 2008 licence agreement
  • documents outlining a summary of changes between PICQ 2004 and PICQ 2008 for Fourth and Fifth Editions

System requirements

Microsoft Access2000® or Access2003® must be installed on your computer in order to run PICQ. A 166MHz Pentium® processor or higher, 32 MB of memory, 15MB of disk space and a CD-ROM drive are required.

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How to order PICQ 2008

PICQ can be ordered by downloading and faxing the order form to us.

PICQ 2008 demonstration

If you are interested in seeing a demonstration of PICQ 2008 or if you require further information contact NCCH on telephone +61 2 9351 9461.

If you are interested in PICQ, you may also be interested in another NCCH quality product, Australian Coding Benchmark Audit? (ACBA), a coding audit tool based on recoding a sample of patient episodes to identify coding discrepancies and distinguish between coder errors and system errors.

Performance Indicators for Coding Quality (PICQ) 2008

PICQ 2006 v5.0 July 2006 is also available, contact NCCH for further information. PICQ 2006 incorporates indicators for ICD-10-AM/ACHI/ACS First Edition (118 indicators), Second Edition (117 indicators), Third Edition (126 indicators) Fourth Edition (223 indicators) and Fifth Edition (248 indicators).

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