Background: Accurate identification of stroke using International Classification of Diseases (ICD-10-AM) codes is needed for efficient and reliable disease surveillance.
Aims: The Australia and New Zealand Stroke Coding Working Group aims to improve the quality of clinical documentation and clinical coding for stroke. We describe progress since the group formed in 2020.
Methods: The group meets quarterly and comprises health information managers (HIMs), clinical coders, stroke registry representatives, neurologists, stroke physicians, database managers, epidemiologists, statisticians and government representatives (AIHW, Victorian and NSW Departments of Health). The initiatives of the group include i) free stroke coding education program; ii) free stroke clinical documentation education program; iii) a validation study to compare brain imaging reports with ICD-10-AM codes and clinician diagnoses in the Australian Stroke Clinical Registry. To support improved documentation and coding practice, a submission was made to the Independent Hospital and Aged Care Pricing Authority (IHACPA).
Results: Over 16 meetings, with an average of 15 attendees each. The education program has reached >1600 HIMs and clinical coders, significantly improving knowledge in 9/12 aspects of stroke knowledge. The 10-minute self-paced stroke clinical documentation education program is currently being implemented for clinicians in Australia and New Zealand. Data collection is underway for the imaging validation study at four Australian hospitals. Our submission to IHACPA has resulted in changes to the Australian Coding Standards for stroke in the ICD-10-AM Thirteenth Edition.
Conclusion: The long-term impact of these initiatives will be evaluated including ongoing monitoring of coding using stroke registry and government administrative data.