Optimise Healthcare GroupPathway SOPs
Governance & data

26ICB Coding & Activity Recording

Owner
Lauren, from the morning meeting
Trigger
An appointment takes place, or a patient does not attend.

Uses

27Invoicing

Purpose

Capturing the coded activity data the ICB requires in order for the service to be paid.

Procedure

  1. At the morning meeting, every appointment and every DNA is documented.
  2. Lauren records the activity on the ICB coding tab of the referral sheet.
  3. Record the activity code set by the ICB - this is what enables billing. A titration review is activity code 3; shared care is activity code 4.
  4. Record the condition code, which depends on whether the patient is ADHD or ASD.
  5. Record the date of the appointment.
  6. Record the outcome code. Attended is 7 and DNA is 3, but the full set is more granular - attended and needs treatment, attended and given a diagnosis, attended and not given a diagnosis, did not attend. Use the code matching the actual outcome.
  7. Record the assessment type where relevant: ASD face to face, ASD virtual, ADHD face to face, ADHD virtual. Then complete the remaining identifying and organisational fields (below).
  8. Record the invoice number once raised (27).

Fields recorded

Activity code (3 titration review / 4 shared care) · condition code (ADHD / ASD) · assessment type · date of appointment · outcome code per appointment (1st, 2nd, 3rd) · DNA outcome codes · GP · GP code · GP postcode · Care Act ID · Care Contact ID · patient postcode · Semble ID · funding stream · ICB · locality · invoice number

Notes

  • Outcome codes 7 and 3 are used for Manchester. No other ICB currently asks for them.
  • An outcome code is recorded against each appointment separately - first, second and third - rather than one code per patient.
  • Everything recorded before the appointment fields is referral data. Everything from the appointment fields onward is captured at morning meeting.

Open points

  • The full outcome code set. Codes 7 and 3 are confirmed; the codes for attended-with-diagnosis, attended-without-diagnosis and attended-needs-treatment are not yet written down.
  • Whether the ICB code set is documented anywhere that can be attached to this SOP.
  • How Care Act ID and Care Contact ID are generated.

Flowchart