Malnutrition coding shortfalls in Australian and New Zealand hospitals

Ekta Agarwal, Maree Ferguson, Merrilyn Banks, Judith Bauer, Sandra Capra, Elisabeth Isenring

Research output: Contribution to journalArticleResearchpeer-review

10 Citations (Scopus)
110 Downloads (Pure)

Abstract

Aim: The International Classification of Diseases, version 10, Australian modification (ICD-10-AM) is used to classify diseases in hospital patients in Australia and New Zealand. ICD-10-AM defines malnutrition as '[body mass index] BMI <18.5kg/m 2 or unintentional weight loss of ≥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 hospitals. This study determined if malnourished participants were assigned malnutrition-related codes according to ICD-10-AM. Methods: The ANCDS recruited acute care patients from 56 hospitals. 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 <18.5kg/m 2, SGA-B (moderately malnourished) or SGA-C (severely malnourished). After 3 months, in this prospective cohort study, staff members from each hospital's health information/medical records department provided coding results for malnourished participants. Results: Malnutrition was prevalent in 30% (n = 869) of the cohort (n = 2976) and a significantly small number of malnourished patients were coded for malnutrition (n = 162, 19%, P < 0.001). In 21 hospitals, none of the malnourished participants were coded. Conclusions: This is the largest study to provide a snapshot of malnutrition coding in Australian and New Zealand hospitals. Findings highlight gaps in malnutrition documentation and/or subsequent coding, which could potentially result in significant loss of casemix-related revenue for hospitals. Dietitians must lead the way in developing structured processes for malnutrition identification, documentation and coding.

Original languageEnglish
Pages (from-to)69-73
Number of pages5
JournalNutrition and Dietetics
Volume72
Issue number1
DOIs
Publication statusPublished - Mar 2015
Externally publishedYes

Cite this

Agarwal, Ekta ; Ferguson, Maree ; Banks, Merrilyn ; Bauer, Judith ; Capra, Sandra ; Isenring, Elisabeth. / Malnutrition coding shortfalls in Australian and New Zealand hospitals. In: Nutrition and Dietetics. 2015 ; Vol. 72, No. 1. pp. 69-73.
@article{b11052f411384fdcb68ac3d7c9f6ff63,
title = "Malnutrition coding shortfalls in Australian and New Zealand hospitals",
abstract = "Aim: The International Classification of Diseases, version 10, Australian modification (ICD-10-AM) is used to classify diseases in hospital patients in Australia and New Zealand. ICD-10-AM defines malnutrition as '[body mass index] BMI <18.5kg/m 2 or unintentional weight loss of ≥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 hospitals. This study determined if malnourished participants were assigned malnutrition-related codes according to ICD-10-AM. Methods: The ANCDS recruited acute care patients from 56 hospitals. 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 <18.5kg/m 2, SGA-B (moderately malnourished) or SGA-C (severely malnourished). After 3 months, in this prospective cohort study, staff members from each hospital's health information/medical records department provided coding results for malnourished participants. Results: Malnutrition was prevalent in 30{\%} (n = 869) of the cohort (n = 2976) and a significantly small number of malnourished patients were coded for malnutrition (n = 162, 19{\%}, P < 0.001). In 21 hospitals, none of the malnourished participants were coded. Conclusions: This is the largest study to provide a snapshot of malnutrition coding in Australian and New Zealand hospitals. Findings highlight gaps in malnutrition documentation and/or subsequent coding, which could potentially result in significant loss of casemix-related revenue for hospitals. Dietitians must lead the way in developing structured processes for malnutrition identification, documentation and coding.",
author = "Ekta Agarwal and Maree Ferguson and Merrilyn Banks and Judith Bauer and Sandra Capra and Elisabeth Isenring",
year = "2015",
month = "3",
doi = "10.1111/1747-0080.12116",
language = "English",
volume = "72",
pages = "69--73",
journal = "Nutrition and Dietetics",
issn = "1032-1322",
publisher = "Wiley-Academy",
number = "1",

}

Malnutrition coding shortfalls in Australian and New Zealand hospitals. / Agarwal, Ekta; Ferguson, Maree; Banks, Merrilyn; Bauer, Judith; Capra, Sandra; Isenring, Elisabeth.

In: Nutrition and Dietetics, Vol. 72, No. 1, 03.2015, p. 69-73.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Malnutrition coding shortfalls in Australian and New Zealand hospitals

AU - Agarwal, Ekta

AU - Ferguson, Maree

AU - Banks, Merrilyn

AU - Bauer, Judith

AU - Capra, Sandra

AU - Isenring, Elisabeth

PY - 2015/3

Y1 - 2015/3

N2 - Aim: The International Classification of Diseases, version 10, Australian modification (ICD-10-AM) is used to classify diseases in hospital patients in Australia and New Zealand. ICD-10-AM defines malnutrition as '[body mass index] BMI <18.5kg/m 2 or unintentional weight loss of ≥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 hospitals. This study determined if malnourished participants were assigned malnutrition-related codes according to ICD-10-AM. Methods: The ANCDS recruited acute care patients from 56 hospitals. 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 <18.5kg/m 2, SGA-B (moderately malnourished) or SGA-C (severely malnourished). After 3 months, in this prospective cohort study, staff members from each hospital's health information/medical records department provided coding results for malnourished participants. Results: Malnutrition was prevalent in 30% (n = 869) of the cohort (n = 2976) and a significantly small number of malnourished patients were coded for malnutrition (n = 162, 19%, P < 0.001). In 21 hospitals, none of the malnourished participants were coded. Conclusions: This is the largest study to provide a snapshot of malnutrition coding in Australian and New Zealand hospitals. Findings highlight gaps in malnutrition documentation and/or subsequent coding, which could potentially result in significant loss of casemix-related revenue for hospitals. Dietitians must lead the way in developing structured processes for malnutrition identification, documentation and coding.

AB - Aim: The International Classification of Diseases, version 10, Australian modification (ICD-10-AM) is used to classify diseases in hospital patients in Australia and New Zealand. ICD-10-AM defines malnutrition as '[body mass index] BMI <18.5kg/m 2 or unintentional weight loss of ≥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 hospitals. This study determined if malnourished participants were assigned malnutrition-related codes according to ICD-10-AM. Methods: The ANCDS recruited acute care patients from 56 hospitals. 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 <18.5kg/m 2, SGA-B (moderately malnourished) or SGA-C (severely malnourished). After 3 months, in this prospective cohort study, staff members from each hospital's health information/medical records department provided coding results for malnourished participants. Results: Malnutrition was prevalent in 30% (n = 869) of the cohort (n = 2976) and a significantly small number of malnourished patients were coded for malnutrition (n = 162, 19%, P < 0.001). In 21 hospitals, none of the malnourished participants were coded. Conclusions: This is the largest study to provide a snapshot of malnutrition coding in Australian and New Zealand hospitals. Findings highlight gaps in malnutrition documentation and/or subsequent coding, which could potentially result in significant loss of casemix-related revenue for hospitals. Dietitians must lead the way in developing structured processes for malnutrition identification, documentation and coding.

UR - http://www.scopus.com/inward/record.url?scp=84925868682&partnerID=8YFLogxK

U2 - 10.1111/1747-0080.12116

DO - 10.1111/1747-0080.12116

M3 - Article

VL - 72

SP - 69

EP - 73

JO - Nutrition and Dietetics

JF - Nutrition and Dietetics

SN - 1032-1322

IS - 1

ER -