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| http://dx.doi.org/10.3238/arztebl.2016.0660a | DOI Listing |
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Diagnostic Coding Intensity among a Pneumonia Inpatient Cohort Using a Risk-Adjustment Model and Claims Data: A U.S. Population-Based Study.
Diagnostics (Basel)
June 2022
School of Data Science, University of North Carolina at Charlotte, Charlotte, NC 28223, USA.
Hospital payments depend on the Medicare Severity Diagnosis-Related Group's estimated cost and the set of diagnoses identified during inpatient stays. However, over-coding and under-coding diagnoses can occur for different reasons, leading to financial and clinical consequences. We provide a novel approach to measure diagnostic coding intensity, built on commonly available administrative claims data, and demonstrated through a 2019 pneumonia acute inpatient cohort (N = 182,666).
View Article and Find Full Text PDFImpact of Coding Curriculum on Dermatology Resident Billing.
Cureus
April 2022
Dermatology, Icahn School of Medicine at Mount Sinai, New York, USA.
Article Synopsis
- * Researchers implemented an interventional curriculum involving monthly lectures and quizzes to enhance billing accuracy and analyzed data from patient visits before and after the intervention.
- * Results showed no significant changes in evaluation and management billing accuracy, but there were marked improvements in the accuracy of procedural codes and modifiers after the intervention.
Real-world data and treatment patterns of patients with lower urinary tract symptoms due to benign prostatic hyperplasia in Germany: an observational study using health insurance claims data.
World J Urol
December 2021
Faculty of Medicine, Department of Urology, Medical Centre - University of Freiburg, Freiburg, Germany.
Purpose: Benign prostatic hyperplasia (BPH) is associated with lower urinary tract symptoms (LUTS), representing one of the most common urological conditions. However, insights into the actual healthcare of this patient cohort in Germany are scarce. We aimed to retrospectively analyse management patterns of patients with LUTS in Germany using health insurance claims databases.
View Article and Find Full Text PDFBottom-up innovation for health management capacity development: a qualitative case study in a South African health district.
BMC Public Health
March 2021
Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Background: As part of health system strengthening in South Africa (2012-2017) a new district health manager, taking a bottom-up approach, developed a suite of innovations to improve the processes of monthly district management team meetings, and the practices of managers and NGO partners attending them. Understanding capacity as a property of the health system rather than only of individuals, the research explored the mechanisms triggered in context to produce outputs, including the initial sensemaking by the district manager, the subsequent sensegiving and sensemaking in the team and how these homegrown innovations interacted with existing social processes and norms within the system.
Methods: We conducted a realist evaluation, adopting the case study design, over a two-year period (2013-2015) in the district of focus.
Coding Family Medicine Residency Clinic Visits, 99213 or 99214? A Residency Research Network of Texas Study.
Fam Med
June 2019
University of Texas Health Science Center at San Antonio, Department of Family and Community Medicine.
Background And Objectives: The purpose of this study was to characterize Current Procedural Terminology (CPT) coding patterns for professional services in family physician (FP) residency clinics.
Methods: Trained assistants directly observed during every other FP-patient encounter in 10 clinics affiliated with eight residencies of the Residency Research Network of Texas. Three investigators later independently coded each visit for the highest code level reasonably allowed.
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