An audit of clinical coding for Level II oncoplastic breast surgery in a British district general hospital

Abstract

Background: The evolution of oncoplastic procedures has not necessarily been followed by new or appropriate operative codes. Clinical coding is the method used to transform clinical activity into accessible, classifiable data for analysis. This translates into remuneration based on the payment by results scheme employed by the Department of Health. This audit set out to identify differences between documented activity undertaken and clinical codes generated, focusing on level II oncoplastic breast surgical procedures at a single unit.