使用Rasch方法对CPT代码27279的相对难度和估计工作相对价值单位进行配对比较调查分析。

Paired Comparison Survey Analyses Utilizing Rasch Methodology of the Relative Difficulty and Estimated Work Relative Value Units of CPT Code 27279.

作者信息

Lorio Morgan, Martinson Melissa, Ferrara Lisa

机构信息

Neuro Spine Solutions, P.C., Bristol TN.

Technomics Research, Minneapolis MN.

出版信息

Int J Spine Surg. 2016 Dec 1;10:40. doi: 10.14444/3040. eCollection 2016.

DOI:10.14444/3040

PMID:28377854

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5374999/

Abstract

BACKGROUND

Minimally invasive sacroiliac joint arthrodesis ("MI SIJ fusion") received a Category I CPT code (27279) effective January 1, 2015 and was assigned a work relative value unit ("RVU") of 9.03. The International Society for the Advancement of Spine Surgery ("ISASS") conducted a study consisting of a Rasch analysis of two separate surveys of surgeons to assess the accuracy of the assigned work RVU.

METHODS

A survey was developed and sent to ninety-three ISASS surgeon committee members. Respondents were asked to compare CPT 27279 to ten other comparator CPT codes reflective of common spine surgeries. The survey presented each comparator CPT code with its code descriptor as well as the description of CPT 27279 and asked respondents to indicate whether CPT 27279 was greater, equal, or less in terms of work effort than the comparator code. A second survey was sent to 557 U.S.-based spine surgeon members of ISASS and 241 spine surgeon members of the Society for Minimally Invasive Spine Surgery ("SMISS"). The design of the second survey mirrored that of the first survey except for the use of a broader set of comparator CPT codes (27 vs. 10). Using the work RVUs of the comparator codes, a Rasch analysis was performed to estimate the relative difficulty of CPT 27279, after which the work RVU of CPT 27279 was estimated by regression analysis.

RESULTS

Twenty surgeons responded to the first survey and thirty-four surgeons responded to the second survey. The results of the regression analysis of the first survey indicate a work RVU for CPT 27279 of 14.36 and the results of the regression analysis of the second survey indicate a work RVU for CPT 27279 of 14.1.

CONCLUSION

The Rasch analysis indicates that the current work RVU assigned to CPT 27279 is undervalued at 9.03. Averaging the results of the regression analyses of the two surveys indicates a work RVU for CPT 27279 of 14.23.

摘要

背景

微创骶髂关节融合术（“MI SIJ融合术”）自2015年1月1日起被赋予了I类现行程序编码（CPT）（编码为27279），其工作相对价值单位（“RVU”）被设定为9.03。国际脊柱手术促进会（“ISASS”）开展了一项研究，该研究对两项针对外科医生的独立调查进行了拉施分析，以评估所分配工作RVU的准确性。

方法

设计了一项调查问卷并发送给93名ISASS外科医生委员会成员。调查要求受访者将CPT 27279与其他十个反映常见脊柱手术的CPT对照编码进行比较。调查问卷向受访者展示了每个对照CPT编码及其编码描述符以及CPT 27279的描述，并要求受访者指出CPT 27279在工作量方面比对照编码大、相等还是小。第二项调查问卷被发送给557名美国的ISASS脊柱外科医生成员以及241名微创脊柱外科学会（“SMISS”）的脊柱外科医生成员。第二项调查的设计与第一项调查类似，只是使用了更广泛的对照CPT编码集（27个而非10个）。利用对照编码的工作RVU，进行了拉施分析以估计CPT 27279相对难度，并通过回归分析估计CPT 27279的工作RVU。