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Helpdesk FAQ

Guidance on using the helpdesk

    1. Why, on occasion, are you unable to supply an answer without operation notes and patient care records?
    2. Why are the codes provided in an answer from the helpdesk only stated to be 'recommended'?
    3. Are the resolutions we receive from the helpdesk considered clinical coding national standards?
    4. Why do you provide the codes and then, in some instances, ask us to clarify with our responsible consultant?
    5. Why does it sometimes take longer to get a response?
    6. Are there other resources I can use to find answers to clinical coding queries?
    7. Why do I have to provide so much information on the clinical coding query sheet just to get an answer?
    8. What clinical coding formats do you support?
    9. What exactly do you mean when you ask for 'fully anonymised supporting documentation'

    10. What constitutes supporting documentation?

    11. What happens if there is other source material(s) which provides examples of Clinical Coding? Can we use such information for clinical...

     

    Why, on occasion, are you unable to supply an answer without operation notes and patient care records?

    Each of the helpdesk answers is specific to the question presented to us and therefore not applicable to other similar scenarios - even though it may appear to apply in similar circumstances. The defining factor with each query is the patient notes providing the condition and status of the patient and their condition. Each answer we provide is specific to the patient information provided with each query and we are unable to help assign codes without all the information in the patient record being provided to us (with all personal identity information being removed). Clinical coders must check with their responsible consultants for further clarity before contacting the helpdesk. If that step is unable to provide resolution we are here to help.

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    Why are the codes provided in an answer from the helpdesk only stated to be 'recommended'?

    The helpdesk can only provide codes as 'recommended' as any response to a particular question is based only on the information provided to us. If any information is missing then this has a direct impact on the codes assigned. So a question presented with limited and simple information will limit the answer provided.

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    Are the resolutions we receive from the helpdesk considered clinical coding national standards?

    In instances where no clinical coding national standards exist within the clinical coding reference books or coding clinic, our resolutions can only be considered as "recommendations" and not national standards.

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    Why do you provide the codes and then, in some instances, ask us to clarify with our responsible consultant?

    There are no definitive codes for every scenario in a clinical environment and so it is vital that clinical coders check with their responsible consultant as a matter of course to gather all the necessary information to code accurately. Our helpdesk clinical coding specialists are not at the source to acquire the critical clinical information first hand so we always recommend checking with your clinical colleagues to ensure clinical coding accuracy. This is vital in instances where information in patient medical records is not clear.

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    Why does it sometimes take longer to get a response from the helpdesk?

    There are a number of factors that can affect the length of time it can take to respond to a coding query. These include:

    • adequate anonymised patient notes have not been provided in the first instance and so causing delays;
    • the fluctuating volumes of queries received from both NHS and external organisations (MPs and other health organisations);
    • where clinical input and/or further research is required due to the complexity of the query;
    • the robust quality assurance process which may extend to our monthly technical meetings for more difficult cases;
    • or if the query presents an implication for an existing or additional national standard which requires development.

    Not withstanding that, our helpdesk remains a small core team of specialists handling, on average, over 50 queries a week. We aim to provide a response to standard queries within 10 working days -however in reality answers may be sent sooner than that. Multilayered coding queries, or those which require research before advice can be sent, may take longer than the stated 10 day turnaround time we apply. If this is the case we will contact you and let you know what's happening during the time it takes to provide a response.

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    Are there other resources I can use to find answers to clinical coding queries?

    Yes – in addition to your own organisation's base coding team and clinical colleagues, should your trust have access to the clinical coding academy network you can also approach them for resolution. If you are still unable to get an answer to your coding query, then the NCS Coding Helpdesk is available to help.

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    Why do I have to provide so much information on the clinical coding query sheet just to get an answer?

    Simply, we want to get it right. The more relevant information you can provide, the more accurate our response can be. Often, completing the query form acts as a prompt for something that may not have been considered or overlooked when trying to find an answer. On many occasions just completing the form leads to an action which provides the answer and makes the query unnecessary.

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    What clinical coding formats do you support?

    NCS Helpdesk provides a portal for receipt of queries on a number of national and international coding protocols. The primary source of information provided is based on the recognised global standards for diagnosis found in ICD-10 national standards for procedural coding is maintained through the use of OPCS-4. Our service also provides advice and guidance on matters relating to the training courses we provide for clinical coders as well as advice on SNOMED and cross mapping.

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    What exactly do you mean when you ask for 'fully anonymised supporting documentation'

    All documents and information sent to the Clinical Classifications Helpdesk with any query must be checked before sending to ensure there is no information present that can identify the patient. In short, please remove all references which may identify the individual patient. We do not need to know the name, age, address or any other demographic or personal information as this is not relevant to answer any clinical coding queries.

    Whilst an entire set of medical records is not required for the majority of queries, anonymised clinical information which provides key supporting evidence to help us provide the appropriate accurate answer is always required with every query submitted. Patients, their diagnosis, and the treatment  they receive are all too often not completely the same. Therefore the pertinent, anonymised, clinical information for each and every query is required in order to provide a full and complete response based.

    Please note we will report to the Trust's Caldicott Guardian if clinical information is received with queries which identifies the patient in any way.

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    What constitutes supporting documentation?

    Supporting documentation should be as comprehensive as possible and may include, but is not limited to, hand-written notes, ward attendance records, discharge summaries/letters and so on. If a record exists that provides extra information in support of your query it should be submitted to us to ensure we give as accurate a reply as possible.

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    What happens if there is other source material(s) which provides examples of Clinical Coding? Can we use such information for clinical coding purposes

    There may be other publications which contain clinical coding information and examples which may be used as a point of reference, however they must not be used as a source of national clinical coding standards. Coders must only use the ICD-10 National Clinical Coding Standards reference book, the OPCS-4 Clinical Coding Instruction Manual and the Coding Clinic, officially released by the NHS Classifications Service, as a source of national standards and guidance.

    An example of of such material is The NHS Kidney Care document ‘A guide to recording activity within renal units for national reporting' which contains a number of examples with ICD-10 and OPCS-4 codes assigned. This is not a precise guide to clinical coding and must not be used as a source of national clinical coding standards as indicated in the document:

    ‘This document has been written to support accurate clinical coding in renal services, rather than as a precise guide. It does not replace the standards and guidance provided by the NHS Classifications Service.

    The diagnoses and procedures in the tables are for the different elements of care over a period of time and not strictly separated for each attendance/episode of care.'

    NCS always recommends the use of the National Helpdesk Query Mechanism as the primary route for answers to clinical coding queries.

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