Exploration of child and adolescent psychiatric procedure coding in Rajanukul Institute

Abstract

Objectives The objective of this investigation was to evaluate the consistency and comprehensiveness of psychiatric procedural coding in pediatric and adolescent populations diagnosed with mental health conditions. This endeavor sought to augment the precision and inclusivity of the Rajanukul Institute's database, particularly in anticipation of its scaling up to the departmental or ministerial level.

Materials and Methods This study was survey research, utilizing patient data with coded procedures or diagnosis from the Rajanukul Institute's database between 2017-2020. The Information Technology section imported data according to specified topics, including diagnoses and procedures received. Subsequently, the data were grouped based on diagnosis to examine the concordance between diagnosis and procedures received, in comparison with the disorder group table, standard treatments, and procedure codes that had been reviewed. Analysis was performed on the concordance and completeness of procedure coding.

Results The concordance of procedural coding with diagnosis was 67.27% for outpatient department and 80.00% for inpatient department. The top 3 disorders (Autism spectrum disorder, Intellectual disabilities and Global developmental delay) were highly concordance rate of 80-100%. Completeness for outpatient department without procedure coding was 49.18%, while for inpatient was 97.74%. The majority of incompletely coded services were in the categories of social services and special education. Categories with no procedures included various assessments, psychological testing, and medication counseling

Conclusion The procedural coding practices observed at the Rajanukul Institute generally demonstrate alignment with diagnoses and established standard treatment protocols, particularly evident within major disorder categories. Nevertheless, notable gaps persist in procedural coding completeness, particularly noticeable within the inpatient department setting.