作者: Griffin R. Baum , Geoffrey Stricsek , Mathu A. Kumarasamy , Vineeth Thirunavu , Gregory J. Esper
DOI: 10.1097/BRS.0000000000003801
关键词: Physical therapy 、 Current Procedural Terminology 、 Categorization 、 Medicine 、 Diagnosis-related group 、 Reimbursement 、 Linear regression 、 Retrospective cohort study 、 Health care 、 Coding (social sciences)
摘要: STUDY DESIGN Retrospective cohort study. OBJECTIVE The aim of this study was to analyze how a Current Procedural Terminology (CPT)-based categorization method can predict cost variation in surgical spine procedures. SUMMARY OF BACKGROUND DATA Neck and back disorders affect majority the adult population account for tens billions dollars health care spending each year. In era bundled payments value-based reimbursement, it is imperative surgeons identify sources variability across Historically, has been accomplished using Medicare Severity Diagnosis Related Group (MS-DRG) codes, but they utilize an overly simplistic specificity familiarity CPT coding structure makes better option categorizing differences decision making technique. METHODS Hospital billing data patients undergoing procedure requiring overnight, in-patient stay retrospectively collected over 4 fiscal years (2012-2016) from single system. Linear regression analysis performed assess correlation between and: spine-specific MS-DRG codes; novel CPT-based method; combination codes categorization. RESULTS There were 5020 procedures analyzed with respect 16 different 30 distinct categories (CSCs). results were: R2 = 0.6545 (P < 0.001); CSC R2 = 0.5709 R2 = 0.744 combined methods (P < 0.05). Median difference actual predicted model -$261.00, compared -$727.50 -$478.70 model. CONCLUSION Addition provides enhanced evaluate association when linear surgery.Level Evidence: 3.