改善社区医院新生儿专业计费的方法
Allison Markowsky1,2, Bridget Allard1, Dalton Haslam1,2
1Children's National Hospital, Washington, DC.
Hospital pediatrics
|January 15, 2025
概括
改善社区医院新生儿计费的做法增加了使用更高层次的评估和管理 (E/M) 代码. 这增加了收入,并确保了婴儿护理的适当编码.
科学领域:
- 医疗保健管理的管理
- 医疗计费和编码 医疗计费和编码
- 儿科医院医药 儿科医院医药
背景情况:
- 新生儿是社区医院的重要患者群体,需要不同的护理.
- 新生儿护理的专业计费对收入至关重要,但经常受到供应商对计费代码知识不足的阻碍.
- 对于需要高级监测或治疗的新生儿,医院护理现行程序术语 (CPT) 评估和管理 (E/M) 代码未得到充分利用.
研究的目的:
- 在社区医院环境中,将新生儿的2级和3级医院护理CPT E/M代码的使用率从1%提高到15%.
主要方法:
- 从2022年10月到2023年10月,在一个母婴单位实施了一项流程改进项目.
- 干预措施包括教育,实时指导和改善对计费代码的访问,以解决发现的不足使用问题.
- 追溯图表审查评估了支持代码使用的临床文档的适当性.
主要成果:
- 2级和3级医院护理CPT E/M代码的使用率上升至17%,超过了目标.
- 这导致工作相对价值单位增加了7%,估计每10,000次计费遭遇收入增加了37,805美元.
- 在72%的查看图表中,适当的文档支持代码的使用.
结论:
- 教育举措和改进的计费工具成功提高了新生儿计费代码的适当使用.
- 该项目通过更好的婴儿护理专业计费实践,优化了社区医院环境中的收入.
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