Codificación clínica

A 90-minute, 4-round intermediate Express simulation for Spanish vocational training (Formacion Profesional, grado superior), modules 1517 Extraccion de diagnosticos y procedimientos and 1520 Codificacion sanitaria of the Tecnico Superior en Documentacion y Administracion Sanitarias.

You are Irene Calvache, a new clinical coder in the clinical documentation service of Montesorno District Hospital, a fictional 210-bed public hospital funded by its regional health service per weighted discharge (APR-DRG weight times 4,800 euros a weight unit). Each round is one batch of the quarter's hospital discharge dataset (CMBD), coded in ICD-10-ES.

Round 1: 40 internal-medicine pneumonia discharges whose reports leave out conditions the physician recorded in the notes - you decide how you abstract and how you query the physician. Round 2: 30 surgical discharges with two laparoscopies converted to open surgery and six illegible operative reports. Round 3: management wants the case weight up before the closing - you decide what review you run and what you report.

Round 4: the regional dataset audit flags nine discrepancies - you decide how you answer and with what evidence. The model works with expected values; each round is scored on all batches so far, on coding accuracy, days to close each batch, funding lost or at risk after what documented clarifications recover, and the relationship with the clinical services.

Forwarding clinical reports to a personal email, or adding diagnoses no physician documented, caps the score. The lesson: coding well is also financing the hospital well. Spanish with English.

An intermediate simulation for participants who already know the core concepts of the subject, designed for master's and MBA programmes.