Comparative Billing Reports

CBR201615 Statistical Debriefing

CBR201615

The following is a description of the tables used in CBR201615, Subsequent Hospital Care. There are links that will open the excel files that contain state and national statistics used in the analysis of rendering Part B providers for CBR201615. All of the analyses in this Comparative Billing Report (CBR) include only the Current Procedural Terminology (CPT®) codes 99231-99233. CBR201615 includes claims with dates of service January 1, 2015 to December 31, 2015. These analyses are based on the latest version of claims available from the Integrated Data Repository as of September 7, 2016. In the CBR201615 sample examples of each table can be found. 

 

CPT® Codes, Presenting Problem, and Key Components

Table 1 of CBR201615 provides a presenting problem and key components for CPT® codes 99231 through 99233, as well as the typical time assigned by the CPT® manual.

 

Summary of Your Utilization of CPT® Codes 99231-99233

Table 2 provides a summary of your utilization of the CPT® codes included in this CBR. The total allowed charges, allowed services and distinct beneficiary count are included for each CPT® code. Please note that the totals may not be equal to the sum of the rows. The number of beneficiaries is an unduplicated count for each row and the total. Since it is possible that a beneficiary would have billings for more than one CPT® code, he/she would be counted in the beneficiary count in each applicable row. However, this beneficiary would be counted only once in the total.

 

Percentage of Beneficiaries Discharged within One Day of a CPT® Code 99233 Service

Table 3 provides an analysis of the percentage of beneficiaries discharged within one day of a CPT® code 99233. CPT® codes 99238 and 99239 were used to determine the date of discharge of each beneficiary. If a beneficiary had a CPT® code 99233 service within one day of the discharge code and the beneficiary did not have a death date on file with the IDR, the beneficiary was flagged. The percentage is calculated by taking the number of beneficiaries flagged divided by total number of beneficiaries and then multiplying by 100. Each provider’s percentage is compared to his/her state and the nation using chi-square test at the alpha value of 0.05.

 

To view the percentage of beneficiaries discharged within one day of a CPT® code 99233 in the year for each state and the nation, please select the following link: CBR201615 Percentage of Beneficiaries Discharged within One Day of a CPT® Code 99233.xls

 

Average Allowed Minutes per Visit

Table 4 provides an analysis of the average allowed minutes per visit. Each CPT® code is assigned a value that corresponds to the typical minutes described in the CPT® code description found in table 1. This value is multiplied by the total allowed services for the code to arrive at the weighted services. The sum of all the weighted services is divided by the total number of visits. A visit is defined as a single date of service by beneficiary. Generally, the total number of visits is equal to the number of services. However, if multiple services are allowed for a particular beneficiary and date of service, then these services would be combined in the same visit. The average allowed minutes per visit are calculated by taking the total weighted services divided by total number of visits. Each provider’s average is compared to his/her state and the nation using the t-test at the alpha value of 0.05.

 

To view the average allowed services per visit for all states and the nation, please select the following link: CBR201615 Average Allowed Minutes per Visit.xls

 

Percentage of Total Services Billed as CPT® Code 99233

Table 5 provides an analysis of the percentage of total services billed as CPT® code 99233. The percentage is calculated by taking the number of services for CPT® code 99233 divided by total number of services and then multiplying by 100. Each provider’s percentage is compared to his/her state and the nation using chi-square test at the alpha value of 0.05.

 

To view the percentage of total services billed as CPT® code 99233 for each state and the nation, please select the following link: CBR201615 Percentage of Total Services Billed as CPT® code 99233.xls