新生儿重症监护病房中CPT®编码的争议: - 危急病房与重症监护病房
Satyan Lakshminrusimha1, Clara Song2, Stephen A Pearlman3
1Department of Pediatrics, UC Davis Children's Hospital, Sacramento, CA, USA. slakshmi@ucdavis.edu.
概括
新生儿服务提供者
科学领域:
- 新生儿医学 新生儿医学
- 医疗保健经济学 医疗保健经济学
- 医疗计费和编码 医疗计费和编码
背景情况:
- 新生儿护理的专业补偿是由当前程序术语 (CPT®) 编码级别决定的.
- 对于新生儿,有四种不同的评估和管理 (E&M) 护理水平:重症,密集,常规医院护理和正常的新生儿护理.
- 与这些 E&M 级别相关的工作相对价值单位 (wRVU) 显著影响提供商的补偿.
研究的目的:
- 审查四个新生儿急救和护理水平的基本特征.
- 要突出重症监护和重症监护编码在新生儿科之间的区别.
- 为理解基于编码级别的报销变化提供背景.
主要方法:
- 对新生儿护理CPT®编码指南的审查.
- 对定义每一个四个E&M级别的特征进行分析.
- 对关键和重症监护病房编码标准的比较检查.
主要成果:
- 四个E&M级别 (危急,密集,常规医院,正常新生儿) 有不同的编码要求和相关的wRVUs.
- 关键和重症监护编码之间的复杂性和资源分配存在显著差异.
- 了解这些差异对于准确的计费和退款至关重要.
结论:
- 准确的CPT®编码对于新生儿护理中适当的专业补偿至关重要.
- 跨 E&M 级别的 wRVU 的变化凸显了精确编码的重要性.
- 提供者应了解不断变化的编码实践,以优化患者护理和财务可行性.
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