Western Australian Clinical Coding Authority (WACCA)

Provide oversight, governance and consultancy for the production of WA's clinical coding data

• Provide classification advice to clinical coders and other stakeholders via the WA Coding Query Process. Queries are answered after interrogation of ICD-10-AM/ACHI/ACS and national and jurisdictional Rules; with input from our Clinical Adviser and/or external clinical input. Some queries require referral to the WA Clinical Coding Technical Advisory Group (TAG);
• Provide administration for the WA Clinical Coding Technical Advisory Group (TAG);
• Produce and maintain WA Coding Rules; 
• Escalate queries to the Independent Health and Aged Care Pricing Authority (IHACPA) for national decision-making to support national coding consistency;
• Produce Clinical Coding Guidelines for WA clinical coders. 

Provide consultancy for the use of WA's clinical coding data

• Collaborate with internal and external stakeholders including managers, data analysts, epidemiologists and researchers to provide consultancy during extraction, analysis and reporting of WA's clinical coding data. This includes assistance with interpretation of ICD-10-AM/ACHI/ACS; selection of codes; mapping to ICD-8, ICD-9 and previous Editions of ICD-10-AM; and providing feedback on draft research study manuscripts;

Consult on ICD-10-AM/ACHI/ACS development 

• Represent WA on the national ICD Technical Group (ITG) which is responsible for ICD-10-AM/ACHI/ACS development. WACCA provides extensive input into ITG classification change proposals; including seeking input from TAG members and other WA stakeholders;
• Submit public submissions to the IHACPA with suggestions for improvement to ICD-10-AM/ACHI/ACS;
• Oversight of ICD-10-AM/ACHI/ACS Edition changes, including consultation with WA's coding educators and managers for identification of issues to be submitted via the IHACPA's Frequently Asked Questions process;
• Produce ICD-10-AM/ACHI/ACS Summary of Major Changes for each Edition change.

Clinical coding is translation of clinical documentation about patient care into code format. For example, acute appendicitis is represented by the code 'K35.8'.

A standardised classification system, The International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM), is applied in all Australian acute health facilities. It is based on the World Health Organisation ICD-10 system, updated with the Australian Classification of Health Interventions (ACHI), Australian Coding Standards (ACS) and ICD-O-3 (International Classification of Diseases for Oncology, 3rd edition).

A clinical coder is responsible for abstracting information from clinical documentation and deciding which diagnoses and procedures meet criteria for coding in accordance with classification conventions, standards and rules. The clinical coder then assigns codes for these diagnoses and procedures. 

What is clinical coding information used for?

• Activity Based Funding (ABF) and reimbursement 
  Each inpatient episode's codes and patient data items are processed by grouper software to determine an Australian Refined - Diagnosis Related Group (AR-DRG) for the inpatient episode of care, which informs funding and reimbursement. The AR-DRG classification enables hospital episodes to be grouped into meaningful categories, helping us to better match patient needs to health care resources. 
• Economic modelling and activity modelling
• Health care planning
• Resource allocation and cost analysis
• Patient safety and quality
• Clinical benchmarking and audits
• Research
• Epidemiological studies
• Education

23 May 2022

IHPA Twelfth Edition Education has been released. All users are required to create an account here to access the education.

9 May 2022

Twelfth Edition update

WACCA Twelfth Edition resource documents will be published this week in the Clinical Coding Guidelines accordion below.

Documents will be published throughout the week, starting with Pharmacotherapy and Neoplasms today. These documents aim to provide a 'preview' of major changes, intended to be read prior to completing IHPA Education which is due for release in mid-May (date yet to be advised).

Please be guided by your manager regarding use of any Twelfth Edition resources, to fit in with local education plans at your health service.

Twelfth Edition comes into effect for separations from 1 July 2022. Please see IHPA website for further details about Twelfth Edition.

May 2021

Contracted care

Changes to the reporting of admitted episodes of care involving Contracted Care will come into effect from 1 July 2021.

Reporting of a NEW data element called the Contracted Care Flag (CCF) will come into effect from 1 July 2021 for contracting/funding/purchaser hospitals (also referred to as Hospital A).

The Western Australian Clinical Coding Authority has published Clinical Coding Guidelines: Contracted Care and an accompanying presentation.
For coding-related questions and feedback on Contracted Care, the Guidelines or presentation please e-mail: coding.query@health.wa.gov.au

The reporting and coding of admitted episodes of care, involving Contracted Care, does not apply to all health services in Western Australia.
Coders will be directed by their health service Coding Managers/Health Information Managers if coding of admitted episodes of care, involving Contracted Care, applies to them.

For further information on Contracted Care reporting, see:

• The Admitted Patient Activity Data Business Rules July 2021, Section 9. Contracted Care

• Contracted Care Supplementary Information
  
  (These documents are yet to be published but can be supplied by the Western Australian Clinical Coding Authority on request)

January 2021

Three new ICD-10-AM codes for COVID-19, to be assigned for admitted episodes, came into effect from 1 Jan 2021. 

These codes are:

• U07.3 Emergency use of U07.3 [Personal history of COVID-19]

U07.3 is to be assigned as an additional diagnosis code when documentation indicates the patient previously had confirmed COVID-19 but it is no longer current.

• U07.4 Emergency use of U07.4 [Post COVID-19 condition]

U07.4 is to be assigned as an additional diagnosis code when documentation indicates a current condition is causally related to a previous COVID-19 infection.

• U07.5 Emergency use code U07.5 [Multisystem inflammatory syndrome associated with COVID-19]

U07.5 is to be assigned as a principal or additional diagnosis code when documentation indicates the patient has:

• paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS)
• multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19
• multisystem inflammatory syndrome in adults (MIS-A).

For more detail, please refer to IHPA Coding Rules: Classification of post COVID-19 conditions & Multisystem inflamamatory syndrome associated with COVID-19

September 2020

ICD-10-AM/ACHI/ACS Twelfth Edition and AR-DRG Version 11.0

• ICD-10-AM/ACHI/ACS Twelfth Edition will be implemented on 1 July 2022

• AR-DRG Version 11.0 will be implemented on 1 July 2023

• As a result of the Consultation and review of the AR-DRG and ICD-10-AM/ACHI/ACS Classification Systems, the Independent Hospital Pricing Authority (IHPA) has lengthened the development cycles for the ICD-10-AM/ACHI/ACS and AR-DRG classifications from two to three years. For further information, see the IHPA website (extrernal site).

August 2020

Revised e-mail arrangement for HMDS coding edits:

• Please continue to e-mail commented HMDS edit spreadsheets to: Hmds.edits@health.wa.gov.au

• The newly created e-mail address DOHCoding.Edits@health.wa.gov.au is available for health services to communicate with WACCA about HMDS coding-related edit issues only.

Health services can e-mail this address voluntarily, if they require assistance to resolve a coding-related edit

or

Health services may be requested to make contact with WACCA using this address.

June 2020

Clinical coding guidelines for COVID-19  have been issued by WACCA:

• Clinical coding guidelines: COVID-19

April 2020

COVID-19 classification instructions have been updated by IHPA:

• How to classify COVID-19

March 2020

COVID-19

COVID-19 classification instructions have been issued by the Independent Hospital Pricing Authority (IHPA):

• National Coding Rule TN1530 Coronavirus disease 2019 (COVID-19)
• Guidelines for ICD-10-AM classification of admitted patient care 
  
  

January 2020

ICD-10-AM emergency use code for novel coronavirus (2019-nCoV acute respiratory disease) - U07.1
The World Health Organization has advised international health data collections to assign U07.1 Emergency use of U07.1  as an additional code for documentation of acute respiratory disease due to 2019-nCoV. For example, where documentation states pneumonia due to 2019-nCoV, assign:

J12.8 Other viral pneumonia
B97.2 Coronavirus as the cause of diseases classified to other chapters 
U07.1 Emergency use of U07.1

Guides to Major Eleventh Edition Changes 
The following Guides have been revised and updated since original publication:

• Guide to Major Eleventh Edition Changes - Obstetrics, neonates and genitourinary
• Guide to Major Eleventh Edition Changes - Australian Coding Standards and ICD-10-AM

WACCA Clinical Coding Guidelines
The following Guidelines have been revised and updated in line with Eleventh Edition:

• Clinical Coding Guidelines: ACS 0020 Bilateral/multiple procedures 
• Clinical Coding Guidelines: ACS 0011 Intervention not performed or cancelled and ACS 0019 Intervention abandoned, interrupted or not completed
• Clinical Coding Guidelines: Anaesthesia 
• Clinical Coding Guidelines: Chemotherapy 
• Clinical Coding Guidelines: Malignant neoplasms 
• Clinical Coding Guidelines: Shoulder arthroscopy 
• Clinical Coding Guidelines: Spinal fusion and fixation 
  
  

November 2019

ICD-10-AM emergency use code for vaping-related disorders - U07.0

The World Health Organization has advised international health data collections to assign U07.0 Emergency use of U07.0 as an additional code for conditions related to vaping, i.e. respiratory disease due to vaping, is to be assigned:

J68.9 Unspecified respiratory condition due to chemicals, gases, fumes and vapours
U07.0 Emergency use of U07.0

A national Coding Rule is to be published on 16 December 2019 for the classification of vaping-related disorders.

October 2019

11th Edition
The WA Coding Rules have now been revised and updated in line with Eleventh Edition.

Guides to Major Eleventh Edition Changes were published in early August 2019. These may be revised in the future to incorporate changes following IHPA review of Eleventh Edition issues, particularly focusing on ACS 0002 Additional diagnoses due to issues raised by multiple jurisdictions. The coding community will be advised if the Guides are revised.

Clinical Coding Practice Framework
The Clinical Coding Practice Framework aims to support national consistency in clinical coding practice, by providing guidance in defining and promoting good practices for those involved in the clinical coding process. It was developed by the Health Information Management Association of Australia (HIMAA) in conjunction with the Clinical Coders’ Society of Australia (CCSA), and incorporated feedback from public consultation. It can be accessed from either the HIMAA, CCSA or IHPA website.

The Clinical Coding Practice Framework will be incorporated into the WA Clinical Coding Policy in the near future.

February 2019

10th Edition Summary

The WACCA document: ICD-10-AM/ACHI/ACS Summary of Major Tenth Edition Changes has been modified to correspond with ACCD advice post Tenth Edition implementation. The modified sections are in blue text to show the revised content. The document is listed in the Clinical Coding Guidelines section of our website.

New staff

We have recently welcomed new staff members Cerys Collins and Claire Romaro to the WA Clinical Coding Authority team. 

October 2018

Changes to WACCA website

Audit Discussion Cases and WACCA Newsletters have been removed from this website due to stakeholder feedback that outdated advice was being applied by clinical coders.

Newsletters, Audit Discussion Cases and 3M Codefinder Notes are based on classification rules current at the time of publication. The content is not mandated classification instruction and is not routinely updated in line with practice changes, therefore content may be outdated.

Any saved copies of Audit Discussion Cases and WACCA Newsletters retained by individuals should be used only as a source of historical information. 

Newsletters are replaced by this Latest News section on the website.

WACCA Clinical Coding Guidelines

The following documents are being revised and will soon be published in the Education and resources section of our website:

• Malignant neoplasms;
• Anaesthesia;
• Interpretation of ACS 0020 Bilateral/multiple procedures

A new document soon to be published:

• Chemotherapy

These documents are of an educational nature and undergo consultation with WA Clinical Coding Advisory Group members prior to publication. They are revised and updated with each Edition change.

Eleventh Edition

The ITG consultation period for ICD-10-AM/ACHI/ACS 11^th Edition addenda proposals, and the ACCD’s public consultation process, have now ended.

Key dates for 11^th Edition implementation:

• January 2019: final 11th Edition ITG proposals released. WACCA will circulate to WACCAG members.
• March 2019: 11th Edition classification available for purchase.
• May/June 2019: release of ACCD 11th Edition education material

Western Australian Register of Developmental Anomalies (WARDA) 

WACCA is collaborating with WARDA to improve the data integrity of the WARDA database by translating ICD-9 (including BPA) codes into ICD-10-AM and Orpha numbers. The project will set the WARDA database into the global forefront of being the first known register of developmental anomalies to be mapped retrospectively and into the future with ICD codes.

The WA Clinical Coding Authority provides coding consultancy via the WA Coding Query Process. Queries should be emailed to coding.query@health.wa.gov.au in accordance with this process.

Some coding queries are referred by WACCA to the WA Clinical Coding Technical Advisory Group for creation of a WA Coding Rule or Clinical Coding Guidelines. WA Coding Rules and Clinical Coding Guidelines are mandated by the Admitted Patient Activity Data Business Rules and are accessible via the A-Z Index and Chronological Index. Coders are notified by email when new WA Coding Rules and Clinical Coding Guidelines are published.

Other coding query responses are published in the WACCA Coding Queries workbook on the first Monday of each month. This will facilitate transparency, coding discussion and the production of high quality coding data.

Please refer to the User Guide within the workbook for more information.

The WA Clinical Coding Technical Advisory Group consists of technically-focused clinical coding professionals who share their knowledge, processes and ideas relative to the production of clinical coding data. The primary function of the group is the resolution of coding queries by providing advice to the WA Clinical Coding Authority on existing and proposed ICD-10-AM/ACHI/ACS classification instructions.

Terms of Reference - Clinical Coding Technical Advisory Group (PDF 144KB)

Edition changes

• Preview of 12th Edition Changes - Pharmacotherapy and Neoplasms
• Preview of 12th Edition Changes - Sepsis, bacteraemia, neutropenia, bacterial and viral agents
• Preview of 12th Edition Changes - Antimicrobial resistance (updated December 2022)
• Preview of 12th Edition Changes - ACS 0010 Clinical documentation and general abstraction guidelines
• Preview of 12 Edition Changes - COVID-19
• Preview of 12th Edition Changes - ACS 2119 Socioeconomic and psychosocial circumstances
• Preview of 12th Edition Changes - ACS 0002 Additional diagnoses
  
  
• Guide to Major 11th Edition Changes - ACS 0002 Additional diagnoses
• Guide to Major 11th Edition Changes - ACS 0010 Clinical documentation and general abstraction guidelines
• Guide to Major 11th Edition Changes - Obstetrics, neonates and genitourinary
• Guide to Major 11th Edition Changes - Australian Coding Standards and ICD-10-AM
• Guide to Major 11th Edition Changes - ACHI
  
  
• Summary of major ICD-10-AM/ACHI/ACS 10th Edition changes (PDF 427KB)
• Summary of major ICD-10-AM/ACHI/ACS 9th Edition changes (PDF 274KB)
  
• Summary of major ICD-10-AM/ACHI/ACS 8th Edition changes (PDF 228KB)
• Summary of major ICD-10-AM/ACHI/ACS 7th Edition changes (PDF 69KB)

WACCA Clinical coding guidelines - current

• Clinical coding guidelines: Contracted care (PDF 505KB)
• Presentation for Clinical coding guidelines: Contracted care
• Clinical coding guidelines: Same-day endoscopy with both diagnostic and surveillance components (PDF 355 KB)
• Clinical coding guidelines: ACS 0020 Bilateral/multiple procedures (PDF 436KB)
• Clinical coding guidelines: ACS 0011 Intervention not performed or cancelled and ACS 0019 Intervention abandoned, interrupted or not completed (PDF 263KB)
• Clinical coding guidelines: Anaesthesia (PDF 290KB)
• Clinical coding guidelines: Malignant neoplasms (PDF 213KB)
• Summary of changes to ACS 0401 Diabetes mellitus and intermediate hyperglycaemia effective July 2012 (PDF 343KB)

WACCA Clinical coding guidelines - archived

• Preview of 12th Edition Changes - Antimicrobial resistance (May 2022)
• Clinical coding guidelines: COVID-19 (February 2022) (PDF 629KB)
• Clinical coding guidelines: COVID-19 (June 2020) (PDF 467KB)
• Clinical coding guidelines: Chemotherapy (PDF 222KB)
• Clinical coding guidelines: Shoulder arthroscopy (PDF 207KB)
• Clinical coding guidelines: Spinal fusion and fixation (PDF 264KB)

• MP 0164/21 Patient Activity Data Policy (effective 1 July 2024).

Same-day ACHI Procedure Codes  

The list of Same-day ACHI Procedure Codes supports compliance with Section 6.1 Same day admissions of the Admitted Patient Activity Data Business Rules (effective 1 July 2024).