代码捆绑对医疗保险数量和退款的影响 在内镜鼻手术中
Derek H Liu1, Sina J Torabi1, Benjamin F Bitner1
1Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, California, USA.
概括
美国医疗保险 (Medicare) 的医疗保险.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 卫生经济学 卫生经济学
- 医学编码 医学编码
背景情况:
- 医疗保险在2018年为内镜外科手术 (FESS) 和气球鼻扩张 (BSD) 引入了新的当前程序术语 (CPT) 代码.
- 这些变化可能会影响鼻科的程序量和财务补偿.
研究的目的:
- 分析2018年医疗保险法规变更之前和之后的FESS和BSD程序的数量和退款趋势.
- 评估捆绑编码对鼻科补贴的影响.
主要方法:
- 医疗保险B部分国家总结数据文件 (2010-2022) 的中断时间序列分析.
- 检查FESS和BSD的程序量和退款趋势.
主要成果:
- 在2018年之前,FESS在体积 (2.5%) 和报销 (6.9%) 方面表现出年增长. 在2018年之后,FESS退款大幅下降 (-13.9%),稳定了数量 (0.72%的增长).
- 气球鼻扩张 (BSD) 经历了快速增长 (2011-2015年),并停滞不前. 2018年的代码更改并没有显著改变BSD数量 (-0.6%) 或退款 (11.9%).
- 编码的捆绑似乎有助于减少FESS和BSD的鼻科补偿金.
结论:
- 2018年医疗保险法规的修订导致FESS退款大幅下降,其数量稳定.
- 结合鼻科手术可能会对补偿产生负面影响,尽管在观察期内没有显著改变BSD手术量.
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