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Current Clinical Coding Practices and Implementation of ICD-10 in Africa: A Survey of Nigerian Hospitals

Received: 19 December 2014    Accepted: 23 December 2014    Published: 31 December 2014
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Abstract

Background: Clinical coding is an integral part of health information management (HIM) practice which provides valuable data for healthcare quality evaluation, health resource allocation, health services research, medical billing, public health programming, Case-Mix/DRG funding. The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) is a veritable tool for the effectiveness of clinical coding practices. Objective: This present study determined implementation levels of ICD-10 as well as ICD-10-PCS and clinical coding practices in both public and for-profit hospitals in Nigeria. Methods: We used Chi square (χ2) and Cramer’s V (φc) to assess the level of association between type of workplace and implementations of ICD-10 and clinical coding practices. Statistical significance was set at .05. Result: The study discovered nationwide implementation of ICD-10 (179, 88.2%) and fair adoption of its procedure counterpart (79, 38.9%). Most hospitals in Nigeria especially, for-profit facilities (3, 100%) and tertiary healthcare settings (148, 93.1%) employed HIM professionals (214, 91.5%) to manage their clinical coding processes. Conversely, the study observed that challenges confronting clinical coding processes were enormous. Notable among these were absence of automation (70, 34.5%), lack of political will (51, 48.1%), inadequate clinical coders (153, 74.4%) and suboptimal documentation (186, 91.6). Suggestions to improve clinical coding practices ranges from continuing professional coding education (33, 10.3%) to initiation of Nigerian’s modification of ICD such that ICD-10 will become ICD-10-NGM (1, 0.3%). Conclusion: Most healthcare systems in Nigeria have implemented ICD-10 for coding and classification of diagnoses and procedures and the process is being managed by the right workforce (i.e. HIM professionals) which reassures effectiveness. However, lack of political will, inadequate and unmotivated workforce and suboptimal clinical documentation were among challenges confronting the practice in Nigeria. Therefore, this study suggests advocacy and coding education with a view to modifying the orientation of all stakeholders and to sensitize relevant authorities on the benefits of clinical coding practices in order to maximize its outcome and in effect, improve public health in the country.

Published in American Journal of Health Research (Volume 3, Issue 1-1)

This article belongs to the Special Issue Health Information Technology in Developing Nations: Challenges and Prospects Health Information Technology

DOI 10.11648/j.ajhr.s.2015030101.16
Page(s) 38-46
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Automated Coding, Clinical Coding, Clinical Documentation, Data Quality, Discharge Summary, Health Information Technology, Health Information Management Professionals, ICD-10

References
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Cite This Article
  • APA Style

    Ibrahim Taiwo Adeleke, Olawole Olusegun Ajayi, Ahmed Bolakale Jimoh, Abdullateef Adisa Adebisi, Sunday Akingbola Omokanye, et al. (2014). Current Clinical Coding Practices and Implementation of ICD-10 in Africa: A Survey of Nigerian Hospitals. American Journal of Health Research, 3(1-1), 38-46. https://doi.org/10.11648/j.ajhr.s.2015030101.16

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    ACS Style

    Ibrahim Taiwo Adeleke; Olawole Olusegun Ajayi; Ahmed Bolakale Jimoh; Abdullateef Adisa Adebisi; Sunday Akingbola Omokanye, et al. Current Clinical Coding Practices and Implementation of ICD-10 in Africa: A Survey of Nigerian Hospitals. Am. J. Health Res. 2014, 3(1-1), 38-46. doi: 10.11648/j.ajhr.s.2015030101.16

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    AMA Style

    Ibrahim Taiwo Adeleke, Olawole Olusegun Ajayi, Ahmed Bolakale Jimoh, Abdullateef Adisa Adebisi, Sunday Akingbola Omokanye, et al. Current Clinical Coding Practices and Implementation of ICD-10 in Africa: A Survey of Nigerian Hospitals. Am J Health Res. 2014;3(1-1):38-46. doi: 10.11648/j.ajhr.s.2015030101.16

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  • @article{10.11648/j.ajhr.s.2015030101.16,
      author = {Ibrahim Taiwo Adeleke and Olawole Olusegun Ajayi and Ahmed Bolakale Jimoh and Abdullateef Adisa Adebisi and Sunday Akingbola Omokanye and Mary Kehinde Jegede},
      title = {Current Clinical Coding Practices and Implementation of ICD-10 in Africa: A Survey of Nigerian Hospitals},
      journal = {American Journal of Health Research},
      volume = {3},
      number = {1-1},
      pages = {38-46},
      doi = {10.11648/j.ajhr.s.2015030101.16},
      url = {https://doi.org/10.11648/j.ajhr.s.2015030101.16},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajhr.s.2015030101.16},
      abstract = {Background: Clinical coding is an integral part of health information management (HIM) practice which provides valuable data for healthcare quality evaluation, health resource allocation, health services research, medical billing, public health programming, Case-Mix/DRG funding. The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) is a veritable tool for the effectiveness of clinical coding practices. Objective: This present study determined implementation levels of ICD-10 as well as ICD-10-PCS and clinical coding practices in both public and for-profit hospitals in Nigeria. Methods: We used Chi square (χ2) and Cramer’s V (φc) to assess the level of association between type of workplace and implementations of ICD-10 and clinical coding practices. Statistical significance was set at .05. Result: The study discovered nationwide implementation of ICD-10 (179, 88.2%) and fair adoption of its procedure counterpart (79, 38.9%). Most hospitals in Nigeria especially, for-profit facilities (3, 100%) and tertiary healthcare settings (148, 93.1%) employed HIM professionals (214, 91.5%) to manage their clinical coding processes. Conversely, the study observed that challenges confronting clinical coding processes were enormous. Notable among these were absence of automation (70, 34.5%), lack of political will (51, 48.1%), inadequate clinical coders (153, 74.4%) and suboptimal documentation (186, 91.6). Suggestions to improve clinical coding practices ranges from continuing professional coding education (33, 10.3%) to initiation of Nigerian’s modification of ICD such that ICD-10 will become ICD-10-NGM (1, 0.3%). Conclusion: Most healthcare systems in Nigeria have implemented ICD-10 for coding and classification of diagnoses and procedures and the process is being managed by the right workforce (i.e. HIM professionals) which reassures effectiveness. However, lack of political will, inadequate and unmotivated workforce and suboptimal clinical documentation were among challenges confronting the practice in Nigeria. Therefore, this study suggests advocacy and coding education with a view to modifying the orientation of all stakeholders and to sensitize relevant authorities on the benefits of clinical coding practices in order to maximize its outcome and in effect, improve public health in the country.},
     year = {2014}
    }
    

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  • TY  - JOUR
    T1  - Current Clinical Coding Practices and Implementation of ICD-10 in Africa: A Survey of Nigerian Hospitals
    AU  - Ibrahim Taiwo Adeleke
    AU  - Olawole Olusegun Ajayi
    AU  - Ahmed Bolakale Jimoh
    AU  - Abdullateef Adisa Adebisi
    AU  - Sunday Akingbola Omokanye
    AU  - Mary Kehinde Jegede
    Y1  - 2014/12/31
    PY  - 2014
    N1  - https://doi.org/10.11648/j.ajhr.s.2015030101.16
    DO  - 10.11648/j.ajhr.s.2015030101.16
    T2  - American Journal of Health Research
    JF  - American Journal of Health Research
    JO  - American Journal of Health Research
    SP  - 38
    EP  - 46
    PB  - Science Publishing Group
    SN  - 2330-8796
    UR  - https://doi.org/10.11648/j.ajhr.s.2015030101.16
    AB  - Background: Clinical coding is an integral part of health information management (HIM) practice which provides valuable data for healthcare quality evaluation, health resource allocation, health services research, medical billing, public health programming, Case-Mix/DRG funding. The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) is a veritable tool for the effectiveness of clinical coding practices. Objective: This present study determined implementation levels of ICD-10 as well as ICD-10-PCS and clinical coding practices in both public and for-profit hospitals in Nigeria. Methods: We used Chi square (χ2) and Cramer’s V (φc) to assess the level of association between type of workplace and implementations of ICD-10 and clinical coding practices. Statistical significance was set at .05. Result: The study discovered nationwide implementation of ICD-10 (179, 88.2%) and fair adoption of its procedure counterpart (79, 38.9%). Most hospitals in Nigeria especially, for-profit facilities (3, 100%) and tertiary healthcare settings (148, 93.1%) employed HIM professionals (214, 91.5%) to manage their clinical coding processes. Conversely, the study observed that challenges confronting clinical coding processes were enormous. Notable among these were absence of automation (70, 34.5%), lack of political will (51, 48.1%), inadequate clinical coders (153, 74.4%) and suboptimal documentation (186, 91.6). Suggestions to improve clinical coding practices ranges from continuing professional coding education (33, 10.3%) to initiation of Nigerian’s modification of ICD such that ICD-10 will become ICD-10-NGM (1, 0.3%). Conclusion: Most healthcare systems in Nigeria have implemented ICD-10 for coding and classification of diagnoses and procedures and the process is being managed by the right workforce (i.e. HIM professionals) which reassures effectiveness. However, lack of political will, inadequate and unmotivated workforce and suboptimal clinical documentation were among challenges confronting the practice in Nigeria. Therefore, this study suggests advocacy and coding education with a view to modifying the orientation of all stakeholders and to sensitize relevant authorities on the benefits of clinical coding practices in order to maximize its outcome and in effect, improve public health in the country.
    VL  - 3
    IS  - 1-1
    ER  - 

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Author Information
  • Department of Health Information, Federal Medical Centre, Bida, Nigeria; Centre for Health & Allied Researches, Bida, Nigeria; Health Informatics Research Initiatives in Nigeria, Bida, Nigeria

  • Department of Health Records, Lagos University Teaching Hospital, Idi-Araba, Nigeria

  • Department of Health Information, Federal Medical Centre, Bida, Nigeria; Health Informatics Research Initiatives in Nigeria, Bida, Nigeria

  • Department of Health Information, Federal Medical Centre, Bida, Nigeria; Centre for Health & Allied Researches, Bida, Nigeria; Health Informatics Research Initiatives in Nigeria, Bida, Nigeria

  • Department of Health Information, Federal Medical Centre, Bida, Nigeria; Centre for Health & Allied Researches, Bida, Nigeria; Health Informatics Research Initiatives in Nigeria, Bida, Nigeria

  • Department of Health Information, Federal Medical Centre, Bida, Nigeria; Health Informatics Research Initiatives in Nigeria, Bida, Nigeria

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