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Determining benchmarks for evaluation and management coding in an academic division of general surgery.

Paul C Kuo1, Ann R Douglas, Darren Oleski

  • 1Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.

Journal of the American College of Surgeons
|June 26, 2004
PubMed
Summary
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Academic surgery divisions can increase revenue by optimizing evaluation and management (E&M) coding. This study found that E&M coding is underutilized, representing a significant missed revenue opportunity for surgical departments.

Area of Science:

  • Health Economics
  • Surgical Practice Management

Background:

  • Academic surgery divisions face financial pressures, necessitating revenue enhancement strategies beyond cost-cutting.
  • Evaluation and Management (E&M) coding is a critical, yet often overlooked, revenue source in surgical care.

Purpose of the Study:

  • To assess the revenue potential of E&M coding in an academic general surgery division.
  • To identify opportunities for increased revenue generation through improved E&M coding practices.

Main Methods:

  • Financial records from a Division of General Surgery (Jan 2001-June 2003) were analyzed for inpatient procedures and hospital visits (CPT codes 99231-99233).
  • ICD-9 and All Patient Refined Diagnosis Related Groups (APR-DRG) data were used to identify billable inpatient-days for secondary medical diagnoses.

Related Experiment Videos

Main Results:

  • Actual E&M charges were 40%-47% of predicted minimums during the study period.
  • This underutilization suggests a potential annual revenue increase of $400,000 to $600,000.

Conclusions:

  • E&M coding represents a significant underutilized revenue stream in academic surgery departments.
  • ICD-9 and APR-DRG data can serve as benchmarks for assessing E&M revenue potential.