Optimization of Current Procedural Terminology Coding in Complex Genitourinary Surgical Specimens.

Context.-- Complex surgical specimens are associated with complex Current Procedural Terminology (CPT) coding. Objective.-- To assess and optimize the accuracy of CPT coding of complex genitourinary specimens at our institution. Design.-- Baseline CPT codes for nephrectomy and cystectomy surgical pa...

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Publicado en:Archives of Pathology & Laboratory Medicine Vol. 149; no. 9; pp. 846 - 852
Autores principales: Behrman, David B., Achram, Robert, McClure, Carol, Allen, Beverly E., Miller, Christine, Shoffeitt, Carla J., Magliocca, Kelly R., Steward-Tharp, Scott M., Alexander, Cindy, Triplet, Twanda, Maloney, Catherine, Ritenour, Chad W. M., Harik, Lara R.
Formato: research tables/charts Journal Article
Publicado: College of American Pathologists Sep2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2025
      vid: 149
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      pub: College of American Pathologists
      place: Northfield, Illinois
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        10.5858/arpa.2024-0118-OA
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        atl: Optimization of Current Procedural Terminology Coding in Complex Genitourinary Surgical Specimens.
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        au:
          Behrman, David B.
          Achram, Robert
          McClure, Carol
          Allen, Beverly E.
          Miller, Christine
          Shoffeitt, Carla J.
          Magliocca, Kelly R.
          Steward-Tharp, Scott M.
          Alexander, Cindy
          Triplet, Twanda
          Maloney, Catherine
          Ritenour, Chad W. M.
          Harik, Lara R.
        affil: Departments of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
      sug:
        subj:
          Current Procedural Terminology
          Coding
          Specimen Handling
          Pathology, Clinical
          Cystectomy
          Nephrectomy
          Human
          Retrospective Design
          Record Review
          Descriptive Statistics
          Pearson's Correlation Coefficient
          Funding Source
          Georgia
          Reports
      ab: Context.-- Complex surgical specimens are associated with complex Current Procedural Terminology (CPT) coding. Objective.-- To assess and optimize the accuracy of CPT coding of complex genitourinary specimens at our institution. Design.-- Baseline CPT codes for nephrectomy and cystectomy surgical pathology specimens were examined during a 3-month period. Pathology reports were reviewed for accurate CPT coding, and commensurate tests of change were implemented. Post-test-of-change data were re-collected, analyzed, and compared to the baseline data. Results.-- Baseline data consisted of 71 genitourinary specimens (April to June 2021) and demonstrated undercoding in 46% (n = 33 of 71) of specimens, mostly in specimens with 2 or more billable organs. From findings in baseline data, we implemented test-of-change efforts consisting of awareness, education, and increased documentation and communication between all involved parties. Marked improvement was noted in the coding accuracy of specimens with 2 billable organs (pretest: n = 4 of 21, 19%; posttest: n = 14 of 21, 67%) and 3 or more billable organs (pretest: n = 0 of 16, 0%; posttest: n = 7 of 12, 58%) (P value = .002). Problematic areas included nephrectomy specimens resected with adrenal glands (pretest: n = 2 of 12, 17%; posttest: n = 12 of 14, 86%) and ureters for urothelial carcinoma (pretest: n = 0 of 10, 0%; posttest: n = 3 of 6, 50%), as well as regional lymph nodes commingled with resection specimens (pretest: n = 0 of 11, 0%; posttest: n = 7 of 9, 78%). Conclusions.-- A comprehensive approach involving all stakeholders is necessary for CPT coding of complex surgical specimens. Documentation and familiarity with coding rules, specifically bundling and unbundling, as well as clinical indications for resection, are important factors in optimizing CPT coding.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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