Payment by results

Our local foundation trust persists in miscoding surgical procedures. Checking and having the correct codes applied is taking up a lot of our PBC cluster manager's time. The mistakes seem genuine rather than 'gaming' to inflate the Payment by Results (PbR) costs in favour of the trust. Sometimes the code is for a less expensive procedure than the one we understood the patient was going to have. Despite complaining three times in the past few months to the PCT and hospital, there has been no improvement. How do we to stop this happening?

by Dr David Jenner

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