Analysis of Reimbursement of Genetic Counseling Services at a Single Institution in a State Requiring Licensure.
J Genet Couns
; 26(4): 852-858, 2017 Aug.
Article
em En
| MEDLINE
| ID: mdl-28181058
ABSTRACT
Reimbursement for genetic counseling services was examined at a single institution. Patient encounters utilizing the 96040 CPT® code from 7/31/2009 through 7/31/2013 were reviewed. Exclusion criteria included billing records of patients seen by a physician the same day, self-pay, Medicaid, and Medicare patients. Of the 8,630 encounters with a genetic counselor, 582 encounters were eligible for review. Descriptive statistics (i.e., percentage of encounters receiving some level of reimbursement, average reimbursement rate, number of third party payors providing any level of reimbursement, and number of ICD-9 codes receiving any level of reimbursement) depicted reimbursement of the 96040 CPT® code for the encounters analyzed. Statistical analysis found a significant difference in reimbursement between third party payors that do and do not credential genetic counselors (p < .0001). There was no statistically significant difference between reimbursement rates for primary diagnostic ICD-9 codes when compared to primary diagnostic ICD-9 V codes used. Results will provide a useful baseline for local and national comparisons due to the paucity of data regarding CPT® 96040.
Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Classificação Internacional de Doenças
/
Aconselhamento Genético
/
Reembolso de Seguro de Saúde
Limite:
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Genet Couns
Assunto da revista:
GENETICA MEDICA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Estados Unidos