Surgical CPT Coding Discrepancies: Analysis of Surgeons and Employed Coders.

Surgeon providers and billing professionals use Current Procedural Terminology (CPT) codes to specify patient treatment and associated charges. In the present study, coding discrepancies between surgeons' first pass coding and employed coders' final codes were investigated. A total of 500 patients over 3 months were retrospectively analyzed for coding discrepancies. To quantify the impact of change, codes with the most accumulated discrepancies were studied and change to annual relative value unit (RVU) was determined. Final submission of codes to billing demonstrated a 161% increase in total codes by the professional coders, versus original surgeon-derived codes (1594 vs 987 CPT codes). The most common source of change between the surgeon and coder was the addition of distinct codes by the billing professional (270 patients, 54.51%). These results demonstrate the existence of coding discrepancies. Future investigation will evaluate the communication between surgeons and billing professionals.

Evaluation of Short-term Outcomes Following Overlapping Urologic Surgery at a Large Academic Medical Center.

OBJECTIVE: To explore the effect of overlapping surgery on the risk of adverse outcomes in urologic surgery. METHODS: Coarsened exact matching was used to assess the impact of overlap on outcomes among urologic surgical interventions (n = 4853) over 2 years (2013-2015) at 1 health system. Overlap was categorized as any overlap, beginning overlap or end overlap. Study subjects were matched 1:1 on 11 clinically relevant variables. Serious unanticipated events were studied. RESULTS: Four hundred and thirty-four patients had any overlap and were matched (n = 575, a 75.47% match rate). For beginning/end overlap, matched groups were created (n = 108/83 patients, match rate was 83.07/75.45%, respectively). Among matched patients, any overlap did not predict unanticipated return to surgery at 30 or 90 days. Any overlap predicted neither reoperation, readmission, or ER visits at 30 or 90 days. Overlap patients showed no difference in mortality during follow-up. Beginning/end overlap had a similar lack of association with serious unanticipated events. CONCLUSION: Nonconcurrent overlapping surgery is not associated with adverse outcomes in a large, matched urologic surgery population across 1 academic health system.