This article titled Quality-based health care is based on false assumptions that appeared in the web e-mail brings up several interesting points including the fact that physicians do not possess total control over quality and patients are not one hundred percent compliant.

The following statement really caught my attention: “Failure to recognize the difference between an error and a complication.  While physicians have a strong grasp on the distinct differences between “complication” and “adverse effects/events,” medical records coders do not necessarily have the same level of practical understanding and appreciation for these same distinctions. From a coding perspective, these distinctions translate into specific code categories, ICD 99X.XX series codes for complications and E codes for adverse events. The former series of codes equates to assigning a medical care complication to the physician while the latter series of codes equates to recognizing and classifying the unexpected medical occurrence as an adverse event. This a major distinction that physicians need to be cognizant of and insure the coder’s in their office as well as in the hospital unintentionally assign a complication ICD-9 code and tag the physician unnecessarily with a “complication” when the clinical scenario classifies the situation as an adverse event.


Here is the article


Just some food for thought.