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Related Experiment Videos

Current Procedural Terminology (CPT) coded services provided by nurse specialists

H M Griffith1, K R Robinson

  • 1Office of Disease Prevention and Health Promotion, U.S. Public Health Service, Fargo, ND.

Image--The Journal of Nursing Scholarship
|January 1, 1993
PubMed
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Nurses across nine specialties perform a wide range of Current Procedural Terminology (CPT) coded procedures. This study documents the frequency of these nursing services, highlighting their contribution to healthcare delivery.

Area of Science:

  • Healthcare Services
  • Nursing Practice
  • Health Economics

Background:

  • Current Procedural Terminology (CPT) codes are essential for physician payment claims.
  • Understanding the scope of nursing practice in relation to CPT codes is crucial for healthcare policy.
  • Previous documentation of nurses performing physician-billed procedures is limited.

Purpose of the Study:

  • To identify and quantify the Current Procedural Terminology (CPT) coded procedures performed by nurses across various specialties.
  • To determine the frequency with which nurses perform these CPT coded procedures.
  • To document the extent to which nurses perform services billed under physician payment codes.

Main Methods:

  • A random sample of nurses from nine specialties (school, enterostomal, family nurse practitioner, critical care, oncology, rehabilitation, orthopaedic, nephrology, nurse-midwifery) was surveyed.

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  • Specialty-specific questionnaires were developed with expert panels to identify relevant CPT codes.
  • Data on the number and frequency of CPT coded procedures performed by individual nurses were collected.

    • Main Results:

    • The number of CPT codes identified ranged from 58 (school nurses) to 233 (family nurse practitioners).
    • Individual nurses performed a mean of 18 to 79 coded services, with a range of 0-162 procedures.
    • Physician supervision for these performed services was infrequent.
    • Aggregate allowable charges to Medicare in 1988 for these coded services exceeded $22.7 million.

    Conclusions:

    • Nurses across diverse specialties perform a significant number of procedures that are typically associated with physician billing.
    • The findings suggest that nurses' contributions to patient care, utilizing CPT codes, are substantial and warrant consideration in healthcare policy discussions.
    • Policy makers should consider the full scope of nursing contributions when seeking solutions for healthcare quality, access, and cost.