Comparative Billing Reports

CBR201602 Statistical Debriefing

CBR201602

The following is a description of the tables used in CBR201602, Electrodiagnostic Testing. There are links that will open the Excel files that contain provider specialty and national statistics used in the analysis of rendering Part B providers for CBR201602. All of the analyses in this Comparative Billing Report (CBR) include only the Current Procedural Terminology (CPT®) covered in CBR201602. CBR201602 includes claims with dates of service October 1, 2014 to September 30, 2015.  These analyses are based on the latest version of claims available from the Integrated Data Repository as of January 4, 2016. In the CBR201602 sample examples of each table can be found.

 

Summary of Your Utilization

Table 1 of CBR201602 provides a list of the CPT® codes used in this CBR.  This table includes the category, an abbreviated description, and the summary statistics for an individual provider for each CPT® code. The total allowed charges, allowed services, and distinct beneficiary counts are provided for each row of the table. Please note that the subtotal and total rows may not equal the sum of the rows for the beneficiary column. The number of beneficiaries is an unduplicated count for each row and the total.

 

Average Allowed Charges per Beneficiary

Table 2 provides an analysis of the average allowed charges per beneficiary. It is calculated as the “Total Allowed Charges” divided by the “Total number of Beneficiaries.”  The calculation includes all services and beneficiaries for the CPT® codes included in this CBR for the services allowed with dates of service October 1, 2014 – September 30, 2015. Each provider’s average is compared to his specialty and the nation using the t-test at the alpha value of 0.05.

 

To view the average allowed charges per beneficiary for each specialty and the nation, please select the following link: CBR201602 Average Allowed Charges per Beneficiary.xls.

 

Average Weighted Services by Category

Table 3 provides an analysis of the average weighted services per beneficiary for each CPT® category. It is calculated as the “Total Weighted Services by Category” divided by the “Total Number of Beneficiaries in the Category”. Each provider’s average is compared to his specialty and the nation using the t-test at the alpha value of 0.05.

 

To calculate the numerator, or “Total Weighted Services by Category,” each CPT® code is assigned a value. For EMG and NCS & EMG CPT® are assigned 1, while the NCS CPT® codes are assigned a value that corresponds to the lower number of studies described in the CPT® code description. This value is multiplied by the number of services on the claim line. If multiple claim lines are allowed for a category then these lines are added together to get a total weighted value for each category. Next we calculate the denominator, “Total Number of Beneficiaries in the Category.” This is the number of unique beneficiaries within each billing category.

 

To view the average weighted services per beneficiary for each specialty and the nation, please select the following link: CBR201602 Average Weighted Services by Category.xls.

 

Percentage of Visits with NCS CPT® Codes Only (Excludes Carpal Tunnel)

Table 4 provides an analysis of the percentage of visits with NCS CPT® codes only. This percentage is calculated as the “total number of visits with NCS only CPT® codes” divided by the “total number of visits”, and then multiplied by 100. All NCS billings in which the beneficiary had a diagnosis of carpal tunnel (diagnosis code 354.0) were excluded from the numerator. Each provider’s percentage is compared to his specialty and the nation using the chi-square test at the alpha value of 0.05.

 

To view the percentages of visits with NCS only CPT® codes for all specialties and the nation, please select the following link: CBR201602 Percentage of Visits with NCS CPT Codes Only.xls.