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Basis for Action Codes: Why Accurate Coding is Critically Important

Recently there have been questions regarding the appropriate use of the "Basis for Action" codes. The most important principle to keep in mind for reporting is stated on the NPDB web site in the Querying and Reporting section:

    It is important that all reports and queries you submit are properly completed and contain codes that accurately represent, for example, the type of practitioner, the reportable action, or the purpose of a query. Your accurate reporting and querying results in better information for protecting the public and in fulfilling the mission of the NPDB.

Efforts by the NPDB to improve the completeness and accuracy of the reports have focused on assuring that all required reports are submitted and contain the appropriate information on the action(s) taken and the basis for them. A codes list is provided for all reporting entities to use in selecting the type of action taken and the basis for the action. When submitting a report, it is important that the most accurate codes are selected, and multiple codes can be selected if there are multiple reasons for the actions taken. There are many possible choices, and there is also an "Other" code. "Other" should only be used if there are no codes that match the actual basis for action.

Although we have carefully crafted guidelines that help reporting entities code disciplinary actions correctly, submitting accurate reports is, by law, the legal responsibility of the reporting organization.All appropriate codes should be used from the codes list, when submitting reports to assure complete and accurate reporting.

The information in the NPDB is available to eligible entities through the Query process, and the aggregate data are available to the public for review and for researchers interested in patient safety and the quality of the health professionals practicing in the U.S. As a result, it is important that our data be as accurate as possible, with the reports reflecting to the greatest extent possible the actual actions taken and the reasons for the actions. Potential employers, licensing bodies, and other entities need the most accurate information to make informed decisions.

Our goal is to make NPDB policies easier to understand and to provide clarification to the current guidance for users. If you have any questions about NPDB's policy and expectations on the use of reporting codes, you can email NPDBCompliance@hrsa.gov.

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