Graduate Medical Education, General Surgery Residency Program, University of Kentucky College of Medicine, Lexington, Kentucky, United States of America.
Department of Clinical Nutrition, Center for Health Services Research, University of Kentucky College of Health Sciences, Lexington, Kentucky, United States of America.
PLoS One. 2023 Aug 10;18(8):e0287124. doi: 10.1371/journal.pone.0287124. eCollection 2023.
This study compares documentation and reimbursement rates before and after provider education in nutritional status documentation. Our study aimed to evaluate accurate documentation of nutrition status between registered dietitian nutritionists and licensed independent practitioners before and after the implementation of a dietitian-led Nutrition-Focused Physical Exam intervention at an academic medical center in the southeastern US. ICD-10 codes identified patients from 10/1/2016-1/31/2018 with malnutrition. The percentage of patients with an appropriate diagnosis of malnutrition and reimbursement outcomes attributed to malnutrition documentation were calculated up to 24 months post-intervention. 528 patients were analyzed. Pre-intervention, 8.64% of patients had accurate documentation compared to 46.3% post-intervention. Post-intervention, 68 encounters coded for malnutrition resulted in an estimated $571,281 of additional reimbursement, sustained at 6, 12, 18, and 24 months. A multidisciplinary intervention improved physician documentation accuracy of malnutrition status and increased reimbursement rates.
这项研究比较了营养状况文档记录前后提供者教育对文档和报销率的影响。我们的研究旨在评估在营养为重点的体检干预措施由营养师主导后，美国东南部一家学术医疗中心的注册营养师和持照独立从业者对营养状况的准确记录。ICD-10 代码从 2016 年 10 月 1 日至 2018 年 1 月 31 日识别出营养不良的患者。营养不良的适当诊断和营养不良文档记录所产生的报销结果的百分比计算至干预后 24 个月。共分析了 528 名患者。干预前，有 8.64%的患者的记录准确，而干预后有 46.3%的患者记录准确。干预后，编码为营养不良的 68 次就诊估计带来了 571281 美元的额外报销，这种情况在 6、12、18 和 24 个月时仍在持续。多学科干预提高了医生对营养不良状况的记录准确性，并提高了报销率。
