Delphi method for medical coding

Abstract

Systems and methods provide confirmation of accuracy of determining medical codes for medical records. The technology may include processor control instructions or steps for establishing a collection of medical documents as a test sample and for determining a convergence of assigned medical codes for the sample that have been assigned by a plurality of coders to establish a standard of one or more accepted medical codes for the sample. The technology may include instructions for applying the sample to a coding system to obtain a determined medical code for the sample; and for comparing the determined code to the accepted medical codes to rate the coding system's accuracy. In some embodiments, the determined medical codes may be obtained by a software coding algorithm that automatically assigns medical codes to medical records. Moreover, the comparing step may be performed by an algorithm that automatically calculates a rate of the coding system.

1 . A memory accessible by one or more processors of an automated system for confirming medical coding accuracy, the memory storing instructions executable by the one or more processors comprising:
 processor control instructions to establish a collection of electronic medical documents as a test sample;   processor control instructions to display a user interface to accept assigned medical codes data;   processor control instructions to automatically determine a convergence of assigned medical codes for the test sample that have been assigned by a plurality of coders and establish a standard of one or more accepted medical codes for the test sample, wherein processor control instructions determine the convergence by: comparing each medical code assigned by a plurali t y of coders to other assigned medical codes and calculating an agreement amongst a number of coders from the plurality of coders for a given medical code assigned to the test sample, wherein the number of coders in agreement meets a certain percentage of the plurality of coders; and   processor control instructions to assess accuracy of a coding system based on a correspondence between one or more determined medical codes and the accepted medical codes, wherein the one or more determined medical codes represent coding output obtained by applying the test sample to the coding system.   
     
     
         2 . The memory of  claim 1  wherein the determined medical codes are obtained by a software coding algorithm that automatically assigns medical codes to the collection of electronic medical documents. 
     
     
         3 . The memory of  claim 1  wherein the processor control instructions that assess the accuracy comprise software that automatically calculates a rate of the coding system. 
     
     
         4 . The memory of  claim 1  wherein the plurality of coders includes at least one automated coding system. 
     
     
         5 . The memory of  claim 1  wherein the determined medical codes are obtained by a computer system that assigns medical codes to the collection of electronic medical documents with a user interface of the computer system. 
     
     
         6 . The memory of  claim 1  wherein the plurality of coders includes at least one automated coding system that accepts data medical codes assigned with a user interface of the coding system. 
     
     
         7 . The memory of  claim 1  wherein the plurality of coders includes at least one automated coding system that includes a software algorithm that automatically assigns medical codes to the collection of electronic medical documents.