Ethical and educational considerations in coding hand surgeries

Scott D. Lifchez, Charles F. Leinberry, Michael Rivlin, Philip E. Blazar

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Purpose To assess treatment coding knowledge and practices among residents, fellows, and attending hand surgeons. Methods Through the use of 6 hypothetical cases, we developed a coding survey to assess coding knowledge and practices. We e-mailed this survey to residents, fellows, and attending hand surgeons. In additionally, we asked 2 professional coders to code these cases. Results A total of 71 participants completed the survey out of 134 people to whom the survey was sent (response rate = 53%). We observed marked disparity in codes chosen among surgeons and among professional coders. Conclusions Results of this study indicate that coding knowledge, not just its ethical application, had a major role in coding procedures accurately. Surgical coding is an essential part of a hand surgeon's practice and is not well learned during residency or fellowship. Whereas ethical issues such as deliberate unbundling and upcoding may have a role in inaccurate coding, lack of knowledge among surgeons and coders has a major role as well. Clinical relevance Coding has a critical role in every hand surgery practice. Inconstancies among those polled in this study reveal that an increase in education on coding during training and improvement in the clarity and consistency of the Current Procedural Terminology coding rules themselves are needed.

Original languageEnglish (US)
Pages (from-to)1370-1377
Number of pages8
JournalJournal of Hand Surgery
Issue number7
StatePublished - Jul 2014


  • Coding
  • ethics

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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