Neurosurgery Billing and Reimbursement in 2021

Council of State Neurological Societies

doi:10.1016/j.wneu.2021.04.072

Neurosurgery Billing and Reimbursement in 2021

Council of State Neurological Societies

Department of Neurosurgery

Research output: Contribution to journal › Article › peer-review

Abstract

Practicing neurosurgery in 2021 requires a detailed knowledge of the vocabulary and mechanisms for coding and reimbursement, which should include general knowledge at the global level and fluency at the provider level. It is specifically of interest for the neurosurgeon to understand conceptually the nuances of hospital reimbursement. That knowledge is especially germane as more neurosurgeons become hospital employees. Here we provide an overview of the mechanics of coding. We illustrate the formula to generate physician reimbursement through the current relative value unit structure. We also seek to explain hospital-level reimbursement through the diagnosis-related group structure. Finally, we expand about different and ancillary income streams available to neurosurgeons and provide a realistic assessment including the opportunities and challenges of those entities.

Original language	English
Pages (from-to)	348-352
Number of pages	5
Journal	World neurosurgery
Volume	151
DOIs	https://doi.org/10.1016/j.wneu.2021.04.072
State	Published - Jul 2021

Keywords

Billing
CPT codes
ICD-10 codes
Medicaid
Medicare
Reimbursement

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10.1016/j.wneu.2021.04.072

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title = "Neurosurgery Billing and Reimbursement in 2021",

abstract = "Practicing neurosurgery in 2021 requires a detailed knowledge of the vocabulary and mechanisms for coding and reimbursement, which should include general knowledge at the global level and fluency at the provider level. It is specifically of interest for the neurosurgeon to understand conceptually the nuances of hospital reimbursement. That knowledge is especially germane as more neurosurgeons become hospital employees. Here we provide an overview of the mechanics of coding. We illustrate the formula to generate physician reimbursement through the current relative value unit structure. We also seek to explain hospital-level reimbursement through the diagnosis-related group structure. Finally, we expand about different and ancillary income streams available to neurosurgeons and provide a realistic assessment including the opportunities and challenges of those entities.",

keywords = "Billing, CPT codes, ICD-10 codes, Medicaid, Medicare, Reimbursement",

author = "{Council of State Neurological Societies} and Richard Menger and Brett Youngerman and Dossani, {Rimal Hanif} and Jakub Godzik and Steven Tenny and Jeffrey Cozzens and Nitin Agarwal and Bharat Guthikonda and Kimmell, {Kristopher T.} and Clemens Schirmer and Rosenow, {Joshua M.} and Tumial{\'a}n, {Luis M.}",

note = "Funding Information: Conflict of interest statement: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Publisher Copyright: {\textcopyright} 2021",

year = "2021",

month = jul,

doi = "10.1016/j.wneu.2021.04.072",

language = "English",

volume = "151",

pages = "348--352",

journal = "World Neurosurgery",

issn = "1878-8750",

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T1 - Neurosurgery Billing and Reimbursement in 2021

AU - Council of State Neurological Societies

AU - Menger, Richard

AU - Youngerman, Brett

AU - Dossani, Rimal Hanif

AU - Godzik, Jakub

AU - Tenny, Steven

AU - Cozzens, Jeffrey

AU - Agarwal, Nitin

AU - Guthikonda, Bharat

AU - Kimmell, Kristopher T.

AU - Schirmer, Clemens

AU - Rosenow, Joshua M.

AU - Tumialán, Luis M.

N1 - Funding Information: Conflict of interest statement: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Publisher Copyright: © 2021

PY - 2021/7

Y1 - 2021/7

N2 - Practicing neurosurgery in 2021 requires a detailed knowledge of the vocabulary and mechanisms for coding and reimbursement, which should include general knowledge at the global level and fluency at the provider level. It is specifically of interest for the neurosurgeon to understand conceptually the nuances of hospital reimbursement. That knowledge is especially germane as more neurosurgeons become hospital employees. Here we provide an overview of the mechanics of coding. We illustrate the formula to generate physician reimbursement through the current relative value unit structure. We also seek to explain hospital-level reimbursement through the diagnosis-related group structure. Finally, we expand about different and ancillary income streams available to neurosurgeons and provide a realistic assessment including the opportunities and challenges of those entities.

AB - Practicing neurosurgery in 2021 requires a detailed knowledge of the vocabulary and mechanisms for coding and reimbursement, which should include general knowledge at the global level and fluency at the provider level. It is specifically of interest for the neurosurgeon to understand conceptually the nuances of hospital reimbursement. That knowledge is especially germane as more neurosurgeons become hospital employees. Here we provide an overview of the mechanics of coding. We illustrate the formula to generate physician reimbursement through the current relative value unit structure. We also seek to explain hospital-level reimbursement through the diagnosis-related group structure. Finally, we expand about different and ancillary income streams available to neurosurgeons and provide a realistic assessment including the opportunities and challenges of those entities.

KW - Billing

KW - CPT codes

KW - ICD-10 codes

KW - Medicaid

KW - Medicare

KW - Reimbursement

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DO - 10.1016/j.wneu.2021.04.072

M3 - Article

C2 - 34243668

AN - SCOPUS:85109106393

SN - 1878-8750

VL - 151

SP - 348

EP - 352

JO - World Neurosurgery

JF - World Neurosurgery

ER -

Neurosurgery Billing and Reimbursement in 2021

Abstract

Keywords

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