Cluster coding

Cluster coding is a mechanism of linking related diagnosis codes through use of a diagnosis cluster identifier (DCID) that will enhance the value of coded data. 
 

Why is cluster coding necessary?

While clinical coders assign and sequence codes, the relationship between codes is not always evident when the coded data is analysed. Assigning codes in sequence does not always indicate a relationship and sometimes that sequencing is not retained when the data is processed and validated by information technology (IT) systems.

With cluster coding, the relationship between codes becomes clearer which adds meaning and improves the utility of the data.

The benefits of cluster coding shown in <figure_description> Image transcript below.

Clustering increases the understanding of activity data and provides more powerful information for end users by:

  • identifying relationships between codes, for example multiple poisonings and injuries in the context of accompanying external cause codes
  • enhancing safety and quality reporting, for example identifying hospital acquired complications in unique clusters
  • enhancing reporting of chronic conditions, for example reporting all chronic conditions regardless of whether they meet ACS 0002 additional diagnoses
  • reducing assumptions when interpreting data
  • eliminating the need to review episodes of care to establish relationships between codes
  • supporting future funding models
  • preparing for a potential future implementation of ICD-11, where clustering is a feature.

How will cluster coding work? 

Cluster coding is proposed to be implemented in a staged approach. In stage one, conditions assigned with external cause codes, and supplementary codes for chronic conditions will be allocated to specific clusters. The remaining codes will be allocated a value denoting they are not part of a diagnosis cluster or chronic condition cluster. 

Support for implementation

To support the implementation of cluster coding, the Independent Health and Aged Care Pricing Authority (IHACPA) will provide the following:

  • Guidelines in the Australian Coding Standards (ACS)
    Creation of ACS 0004 Diagnosis cluster identifier (DCID), to provide guidance on the purpose and application of cluster coding for Thirteenth Edition. 
  • Pilot exercise to test the proposed ACS 0004 Diagnosis cluster identifier (DCID)
    IHACPA conducted a pilot exercise in March 2024 to test the proposed classification guidelines. 
  • Enhancements to the electronic code lists (ECLs)
    Thirteenth Edition ECLs will identify codes that require application of the DCID. Flagging relevant codes will assist software vendors in the application of the DCID and allow data collection agencies to formulate edits that will enhance the quality and application of the DCID. 
  • Engagement with stakeholders
    IHACPA are engaging with stakeholders through public consultation, public forums and conducted an industry briefing in April 2024. 
  • Frequently asked questions (FAQs)
    IHACPA has developed responses to commonly asked questions about the implementation and impact of cluster coding.
  • Education
    Education on cluster coding will be available to clinical coders, health information managers, data users, clinical coding auditors and educators, software vendors and tertiary education providers through IHACPA Learn.

Subscribe to the Australian Classification Exchange (ACE) mailing list to keep updated on the implementation of cluster coding

 

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