Objective. To study the impact of information from a physician-entry c
omputerized preanesthetic evaluation system on the coding of Internati
onal Classification of Diseases (ICD-9-CM) diagnoses and on hospital r
eimbursement due to alterations in diagnosis-related group (DRG) codes
. Methods. Nonrandomized, unblinded trial conducted at a 570-bed unive
rsity tertiary care hospital. First without and then with reference to
information contained on computer-based preanesthetic evaluation repo
rts, medical charts were coded by the study institution's usual profes
sional coders for ICD-9-CM discharge diagnoses and DRG assignment. Res
ults, For 22 of 180 charts studied (12%, 95% confidence limits 7.4% to
16.7%), at least one ICD-9-CM diagnosis was added. Three of 84 DRG-ba
sed reimbursements were altered, increasing hospital reimbursement by
1.5%. Conclusions. Supplemental information from a physician-entered,
problem-oriented, computerized preanesthetic evaluation system improve
d discovery of diagnoses in the population studied.