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Physician code creep after the initiation of outpatient volume control program and implications for appropriate
Fu-Wen Liang1, Liang-Yi Wang2, Lin-Yi Liu3
1Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan.
BMC Health Services Research
|February 21, 2020
Summary
Physician code creep, or changing coding for reimbursement, was observed in Taiwan after the Outpatient Volume Control Program (OVCP) was implemented. Education on proper coding practices is effective when linked to reimbursement.
Area of Science:
- Health Services Research
- Medical Economics
- Healthcare Policy
Background:
- Physician code creep, altering coding for reimbursement, is understudied in chronic disease patients.
- Existing research primarily focuses on inpatient or procedural coding changes.
Purpose of the Study:
- To investigate physician diagnostic coding practice changes in response to the Outpatient Volume Control Program (OVCP) in Taiwan.
- To assess coding shifts among patients with chronic diseases in tertiary medical centers.
Main Methods:
- Retrospective observational study of four patient cohorts (intervention and control) from January 2016 to September 2017.
- Analysis of outpatient visits based on four diagnostic coding practices related to OVCP monitoring codes.
Main Results:
- Significant decrease in OVCP monitoring codes as primary diagnoses (-73% to -74%) in tertiary centers.
- Substantial increase in non-OVCP monitoring codes as primary diagnoses (+46% to +73%) in tertiary centers.
- Coding practice changes were less pronounced in clinics compared to tertiary medical centers.
Conclusions:
- Physician code creep was evident following the OVCP initiation in Taiwan.
- Educational interventions on appropriate outpatient coding can be effective when reimbursement incentives are aligned.
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