Shortfalls in malnutrition coding: a mandate for action

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

Research output: Contribution to journalMeeting AbstractResearchpeer-review

Abstract

The International Classification of Diseases, Version 10, Australian modification (ICD-10- AM) is commonly used to classify diseases in hospital patients. ICD-10-AM defines malnutrition as “BMI < 18.5 kg/m2 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 hospitals1. This study determined if malnourished participants were assigned malnutritionrelated codes as per ICD-10-AM. 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/m2, SGA-B (moderately malnourished) or SGA-C (severely malnourished). After three months, in this prospective cohort study, hospitals’ health information/medical records department provided coding results for malnourished participants. Although malnutrition was prevalent in 32% (n= 993) of the cohort (N= 3122), a significantly small number were coded for malnutrition (n= 162, 16%, p<0.001). In 21 hospitals, none of the malnourished participants were coded. 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
Article number136
Pages (from-to)4-4
Number of pages1
JournalNutrition and Dietetics
Volume70
Issue numberS1
DOIs
Publication statusPublished - May 2013
Externally publishedYes
EventDietitians Association of Australia (DAA) 30th national conference - Canberra, Australia
Duration: 23 May 201325 May 2015
Conference number: 30th

Fingerprint

Malnutrition
International Classification of Diseases
Nutritionists
New Zealand
Documentation
Patient Care
Hospital Medical Records Department
Subcutaneous Fat
Nutritional Status
Weight Loss
Cohort Studies
Prospective Studies
Muscles
Health
Surveys and Questionnaires

Cite this

Agarwal, E., Ferguson, M., Banks, M., Bauer, J., Capra, S., & Isenring, E. (2013). Shortfalls in malnutrition coding: a mandate for action. Nutrition and Dietetics, 70(S1), 4-4. [136]. https://doi.org/10.1111/1747-0080.12034
Agarwal, Ekta ; Ferguson, Maree ; Banks, Merrilyn ; Bauer, Judy ; Capra, Sandra ; Isenring, Elisabeth. / Shortfalls in malnutrition coding: a mandate for action. In: Nutrition and Dietetics. 2013 ; Vol. 70, No. S1. pp. 4-4.
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abstract = "The International Classification of Diseases, Version 10, Australian modification (ICD-10- AM) is commonly used to classify diseases in hospital patients. ICD-10-AM defines malnutrition as “BMI < 18.5 kg/m2 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 hospitals1. This study determined if malnourished participants were assigned malnutritionrelated codes as per ICD-10-AM. 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/m2, SGA-B (moderately malnourished) or SGA-C (severely malnourished). After three months, in this prospective cohort study, hospitals’ health information/medical records department provided coding results for malnourished participants. Although malnutrition was prevalent in 32{\%} (n= 993) of the cohort (N= 3122), a significantly small number were coded for malnutrition (n= 162, 16{\%}, p<0.001). In 21 hospitals, none of the malnourished participants were coded. 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.",
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Agarwal, E, Ferguson, M, Banks, M, Bauer, J, Capra, S & Isenring, E 2013, 'Shortfalls in malnutrition coding: a mandate for action' Nutrition and Dietetics, vol. 70, no. S1, 136, pp. 4-4. https://doi.org/10.1111/1747-0080.12034

Shortfalls in malnutrition coding: a mandate for action. / Agarwal, Ekta; Ferguson, Maree; Banks, Merrilyn; Bauer, Judy; Capra, Sandra; Isenring, Elisabeth.

In: Nutrition and Dietetics, Vol. 70, No. S1, 136, 05.2013, p. 4-4.

Research output: Contribution to journalMeeting AbstractResearchpeer-review

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T1 - Shortfalls in malnutrition coding: a mandate for action

AU - Agarwal, Ekta

AU - Ferguson, Maree

AU - Banks, Merrilyn

AU - Bauer, Judy

AU - Capra, Sandra

AU - Isenring, Elisabeth

PY - 2013/5

Y1 - 2013/5

N2 - The International Classification of Diseases, Version 10, Australian modification (ICD-10- AM) is commonly used to classify diseases in hospital patients. ICD-10-AM defines malnutrition as “BMI < 18.5 kg/m2 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 hospitals1. This study determined if malnourished participants were assigned malnutritionrelated codes as per ICD-10-AM. 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/m2, SGA-B (moderately malnourished) or SGA-C (severely malnourished). After three months, in this prospective cohort study, hospitals’ health information/medical records department provided coding results for malnourished participants. Although malnutrition was prevalent in 32% (n= 993) of the cohort (N= 3122), a significantly small number were coded for malnutrition (n= 162, 16%, p<0.001). In 21 hospitals, none of the malnourished participants were coded. 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 - The International Classification of Diseases, Version 10, Australian modification (ICD-10- AM) is commonly used to classify diseases in hospital patients. ICD-10-AM defines malnutrition as “BMI < 18.5 kg/m2 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 hospitals1. This study determined if malnourished participants were assigned malnutritionrelated codes as per ICD-10-AM. 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/m2, SGA-B (moderately malnourished) or SGA-C (severely malnourished). After three months, in this prospective cohort study, hospitals’ health information/medical records department provided coding results for malnourished participants. Although malnutrition was prevalent in 32% (n= 993) of the cohort (N= 3122), a significantly small number were coded for malnutrition (n= 162, 16%, p<0.001). In 21 hospitals, none of the malnourished participants were coded. 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.

U2 - 10.1111/1747-0080.12034

DO - 10.1111/1747-0080.12034

M3 - Meeting Abstract

VL - 70

SP - 4

EP - 4

JO - Nutrition and Dietetics

JF - Nutrition and Dietetics

SN - 1032-1322

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ER -