periprosthetic fractures, had not been coded; loosing these additional tariffs of 70% uplift.We involved and educated our coding staff and created a 'tick box' sticker to be placed on every revision hip operation-record and completed by the operating surgeon.Our subsequent tariff uplift for these procedures has been significant.Conclusion: Joint replacement surgery is being performed in an ever younger and more active population.Patients are increasingly likely to outlive their prosthesis and periprosthetic fracture rates are set to continue rising.In the modern NHS, surgeons must have a good understanding of complex tariffs.Coding staff is a notoriously poorly paid and undervalued component of any Hospital Trust, and invariably lack the surgical experience to interpret complex procedures.Trusts must take measures to ensure such large tariff uplifts are not missed for complex procedures.We explain the tariff process and discuss how improvements can easily be achieved.
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Clement et al. (2009) studied this question.