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初级保健活检及消融手术的编码与报销

Coding and reimbursement of primary care biopsy and destruction procedures.

作者信息

Zuber T J, Purvis J R

机构信息

Department of Family Medicine, East Carolina University School of Medicine, Greenville, NC 27858-4354.

出版信息

J Fam Pract. 1992 Oct;35(4):433-41.

PMID:1402732
Abstract

Current medical practice requires physicians to accurately report services provided to patients. Billing for destruction of benign and malignant lesions and for surgical, needle, and endoscopic biopsy procedures involves the selection of specific 1992 Current Procedural Terminology (CPT) codes. Payment for these procedures by third-party payers often requires the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) coding for neoplastic lesions. This review explains the proper codes to use in identifying common biopsy and destruction procedures performed by primary care physicians. The Health Care Financing Administration's relative value units and one state's published Medicaid payment rates are included for each procedure code. Instructions for selecting site-specific biopsy and destruction codes are provided.

摘要

当前的医疗实践要求医生准确报告为患者提供的服务。对良性和恶性病变的切除以及外科、针吸和内镜活检程序进行计费,需要选择特定的1992年现行程序术语(CPT)编码。第三方支付方对这些程序的支付通常需要对肿瘤病变进行国际疾病分类第九版临床修订本(ICD-9-CM)编码。本综述解释了在识别初级保健医生进行的常见活检和切除程序时应使用的正确编码。每个程序编码都包括医疗保健财务管理局的相对价值单位和一个州公布的医疗补助支付率。还提供了选择特定部位活检和切除编码的说明。

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