The ever topical spectre of coding in otolaryngology is comprehensively evaluated in this article. It attempts to debunk the mystique of current coding practices and the challenge of health informatics in the modern NHS. A total of 3131 randomly selected otolaryngology patients initially coded in the standard manner were evaluated by a clinician-auditor multi-disciplinary team. This was substantially larger than the sample size used to audit coding accuracy in the entire NHS by the audit commission! Overall this led to a 13% rate of change in both the primary procedure and underlying diagnosis. Coding data informs resource allocation and has an influence on clinical prioritisation within the NHS. Attempts to decrease variability and drive excellence in coding should remain a priority for clinicians as well as managers yet achieving this continues to present difficulties. 

An audit of the nature and impact of clinical coding subjectivity variability and error in otolaryngology.
Nouraei S, Hudovsky A, Virk J, et al.
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Andy Hall

FRCS (ORL-HNS), North Thames, ST7 Northwick Park Hospital, London, UK.

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