Recognizing Variations in Primary Palatoplasty Billing: A Review of 9827 Cases.

IF 1.1 4区医学 Q2 Dentistry Cleft Palate-Craniofacial Journal Pub Date : 2024-12-12 DOI:10.1177/10556656241304213

Ashlie A Elver, Wesley Q Zhang, Nancy K Perry, Jamie Lewis, Laura S Humphries, Ian C Hoppe

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引用次数: 0

Abstract

Objective: Identify unbundling trends in primary palatoplasty.

Design: Retrospective study utilizing the American College of Surgeon Pediatric National Surgical Quality Improvement Program (PNSQIP).

Setting: Records available from 2016 to 2021.

Patients: All patients with primary CPT (current procedural terminology) code 42200 (palatoplasty for cleft palate, soft and/or hard palate only).

Interventions: Cohorts compared "unbundled": additional CPT code 42235 (repair of anterior palate, including vomer flap) vs. "bundled": 42200 billed alone.

Main outcome measures: Operative time, surgical specialty, and other perioperative variables.

Results: In total, 9827 had primary CPT 42200. Of these, 671 (6.8%) were unbundled. Operative time was longer in unbundled (157.08 min vs. 133.16 min; P < .001). Plastic surgeons were less likely to unbundle (6.2% vs. otolaryngology, 9.12%; P < .001).

Conclusions: Variations in primary palatoplasty billing exist. Longer operative times in unbundled cases suggest added complexity. Undervaluation of craniofacial CPT codes may contribute to non-standard billing practices.

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初诊腭成形术收费差异的认识：9827例回顾。

目的：探讨初级腭裂成形术的发展趋势。设计：利用美国外科医师学会儿科国家手术质量改进计划（PNSQIP）进行回顾性研究。设定：2016年至2021年有记录。患者：所有原发性CPT（现行程序术语）代码42200的患者（仅用于腭裂，软腭和/或硬腭的腭成形术）。干预措施：队列比较“未捆绑”：额外的CPT代码42235（前腭修复，包括腭瓣）与。“捆绑”：单独计费42200。主要观察指标：手术时间、手术专科和其他围手术期变量。结果：共9827例原发性CPT 42200。其中，671个（6.8%）未捆绑销售。非捆绑组手术时间更长（157.08 min vs 133.16 min）；结论：初级腭成形术的收费存在差异。在非捆绑的情况下，较长的操作时间表明增加了复杂性。颅面CPT代码的低估可能导致不标准的计费实践。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cleft Palate-Craniofacial Journal DENTISTRY, ORAL SURGERY & MEDICINE-SURGERY

CiteScore

2.20

自引率

36.40%

发文量

审稿时长

4-8 weeks

期刊介绍： The Cleft Palate-Craniofacial Journal (CPCJ) is the premiere peer-reviewed, interdisciplinary, international journal dedicated to current research on etiology, prevention, diagnosis, and treatment in all areas pertaining to craniofacial anomalies. CPCJ reports on basic science and clinical research aimed at better elucidating the pathogenesis, pathology, and optimal methods of treatment of cleft and craniofacial anomalies. The journal strives to foster communication and cooperation among professionals from all specialties.