2.50
Hdl Handle:
http://hdl.handle.net/10755/158349
Type:
Presentation
Title:
Codes Utilized at Nurse-Managed Centers: Results from A National Pilot Survey
Abstract:
Codes Utilized at Nurse-Managed Centers: Results from A National Pilot Survey
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2006
Author:Vonderheid, Susan, PhD, RN
P.I. Institution Name:University of Illinois at Chicago
Title:Assistant Professor
Contact Address:College of Nursing, 845 S. Damen Avenue, Chicago, IL, 60612, USA
Contact Telephone:312-996-7982
Co-Authors:Violet H. Barkauskas, PhD, RN, FAAN, Associate Professor; Joanne M. Pohl, PhD, RN, FAAN, Associate Dean; and Juliann G. Sebastian, PhD, Professor
Background: Evidence suggests that Academic Nurse-Managed Centers (ANMCs) serve an important role in the U.S. health care system. Yet, these centers often struggle to remain financially viable. Little is known about the services provided by ANMCs and how these services might contribute to the health care system. Coding services drives reimbursement, reflects level of adherence to federal coding guidelines, and enables comparison with benchmarks for other primary care providers. Purpose: An aim of the overall study was to develop profiles of the populations served, problems addressed, and interventions provided in ANMCs. The purpose of this paper is to describe the services provided by ANMCs using Current Procedural Terminology (CPT) data from a pilot national survey. Subjects: Directors of 64 ANMCs completed surveys in 2003. Method: A descriptive study design using surveys was employed. Centers listed the most frequently utilized Evaluation and Management (EM) and non-EM codes. Results: 56% of ANMCs use CPT, 34% use it in billing. The most frequently utilized EM CPT codes were those used to classify outpatient services for new and established patients. Seven centers reported Preventive Medicine (PM) codes. No center reported home visit and counseling codes. Seven centers reported non-EM codes. The top non-EM CPT codes were services associated with patients' tests. Conclusions: While over 50% of ANMCs reported using CPT, only 33% reported frequencies. The lack of reporting may be related to the absence of computerized data systems. Only 34% used CPT codes specifically for billing, possibly reflecting the number of centers that rely on grants/donations for funding rather revenue. More centers utilized outpatient codes than PM codes suggesting more visits are for episodic care rather than health maintenance, and/or utilizing codes is driven by insurance. More centers reported using established rather than new patient codes suggesting centers have developed a solid patient base.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleCodes Utilized at Nurse-Managed Centers: Results from A National Pilot Surveyen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158349-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Codes Utilized at Nurse-Managed Centers: Results from A National Pilot Survey</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Vonderheid, Susan, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Illinois at Chicago</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">College of Nursing, 845 S. Damen Avenue, Chicago, IL, 60612, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">312-996-7982</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">vonde@uic.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Violet H. Barkauskas, PhD, RN, FAAN, Associate Professor; Joanne M. Pohl, PhD, RN, FAAN, Associate Dean; and Juliann G. Sebastian, PhD, Professor</td></tr><tr><td colspan="2" class="item-abstract">Background: Evidence suggests that Academic Nurse-Managed Centers (ANMCs) serve an important role in the U.S. health care system. Yet, these centers often struggle to remain financially viable. Little is known about the services provided by ANMCs and how these services might contribute to the health care system. Coding services drives reimbursement, reflects level of adherence to federal coding guidelines, and enables comparison with benchmarks for other primary care providers. Purpose: An aim of the overall study was to develop profiles of the populations served, problems addressed, and interventions provided in ANMCs. The purpose of this paper is to describe the services provided by ANMCs using Current Procedural Terminology (CPT) data from a pilot national survey. Subjects: Directors of 64 ANMCs completed surveys in 2003. Method: A descriptive study design using surveys was employed. Centers listed the most frequently utilized Evaluation and Management (EM) and non-EM codes. Results: 56% of ANMCs use CPT, 34% use it in billing. The most frequently utilized EM CPT codes were those used to classify outpatient services for new and established patients. Seven centers reported Preventive Medicine (PM) codes. No center reported home visit and counseling codes. Seven centers reported non-EM codes. The top non-EM CPT codes were services associated with patients' tests. Conclusions: While over 50% of ANMCs reported using CPT, only 33% reported frequencies. The lack of reporting may be related to the absence of computerized data systems. Only 34% used CPT codes specifically for billing, possibly reflecting the number of centers that rely on grants/donations for funding rather revenue. More centers utilized outpatient codes than PM codes suggesting more visits are for episodic care rather than health maintenance, and/or utilizing codes is driven by insurance. More centers reported using established rather than new patient codes suggesting centers have developed a solid patient base.</td></tr></table>en_GB
dc.date.available2011-10-26T20:57:42Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:57:42Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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