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PBC essential to tackle miscoding

Practice-based commissioning consortiums are essential to tackling the problem of miscoding of procedures in the NHS, a GP has warned.

Dr Luke Twelves, a GP in Huntingdon, said the 22 practice consortium he chairs had queried 54 per cent of its Healthcare Resource Groups (HRG) codes and was still

awaiting responses from local hospitals.

For his 8,000-patient practice alone, the sum in dispute amounted to £45,000 a month.

Dr Twelves said: 'We may find that when the queries come back the real sums

are a lot less, but it gives

an idea of the level of interest with which we are looking at things.'

Dr Twelves said his local PCT and hospital had been unable to resolve queries over coding and had been forced to turn to an

independent assessor.

'What surprised us was the level of complexity,' he said.

'It's emphasising the importance of data to us and guiding us to where we should look next. The big effect it has on practice-based commissioning is that it emphasises it's very

difficult to do this level of work at a practice level.'

New, larger PCTs should be better placed to negotiate with hospital trusts to resolve coding issues.

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