About Clinical Coding

Clinical Coding involves grouping aspects of patient information and characteristics into categories based on standard criteria, logic and conventions.

Clinical statements written in a medical history are analysed to assign standard codes as prescribed by the coding rules applicable to the International Classification of Diseases (ICD) tenth version, Australian Modification (AM) classification system, 12th Edition. This classification system consists of around 155,000 codes!

The record pertaining to every hospital discharge is coded according to this classification system to reflect the reason for any hospital admission.

The Independent Health and Aged Care Pricing Authority (IHACPA), an independent Government Agency, undertakes reviews and updates of existing classifications relative to a number of different health service categories.

These codes form part of routine data collections required for:

• Morbidity Reporting
• Research
• Clinical audits
• Epidemiological studies
• Measuring treatment effectiveness
• Assessing health trends
• Hospital funding
• Cost analysis
• Resource allocation
• Health Care Planning purposes

The ICD-10-AM codes and a number of other routinely collected variables including: age, sex, separation mode, length of stay, same-day status, admission weight for neonates and hours of mechanical ventilation are used to group the number and type of patients treated in admitted acute episodes of care, into a more manageable number of categories.

Each group is clinically meaningful and relates to the resources required by a hospital. These are known as Australian Refined Diagnosis Related Groups (AR-DRGs), an Australian admitted patient classification system. They are used to calculate public hospital funding on an activity basis.

They are also used for:

• Performance management
• Benchmarking
• Bunding agreements between private hospitals and insurers
• Education
• Epidemiology
• Research into the quality of healthcare and patient safety
• Health service planning

Clinical coding is part of a Health Information Professional’s position. Clinical coding positions may be referred to as a Clinical Coding Officer, Diagnostic Coder, Medical Coder, Medical Records Coder, or Nosologist.

The Independent Health and Aged Care Pricing Authority (IHACPA), an independent Government Agency, undertakes reviews and updates of existing classifications relative to a number of different health service categories.

The World health Organisation (WHO) has authorised the publication of ICD-10 classification system. In Australia this includes the use of the Australian Classification of Health Interventions (ACHI) and applies the Australian Coding Standards (ACS), known as the Australian Modification (AM).

The US has developed and uses its own Clinical Modification (CM) plus their Procedure Coding System (PCS).

Many countries have adopted earlier editions of this Australian version, others have adopted the US version.

eHealth Education (eHE) is a Registered Training Organisation (RTO) approved by the Australian Skills Quality (ASQA) to deliver the Diploma of Clinical Coding using a simulation cloud based system (eHRoL). The Diploma is designed to prepare Australian students for a clinical coding career.

Other countries don’t necessarily require this comprehensive qualification to meet their coding skill requirements. eHE also provides NON-RTO Clinical Coding courses to meet this international market need.

You can learn more about the options for Australian and International Students by reading on below.