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Clinical Research
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The Relationship between Physician level of Service and Facility Level of Service in 81,142 Outpatient Wound Center Visits First Author: Caroline Fife Authors: Gordon Otto, PhD, David Walker, CHT, Brett Thomson, Karen Swaby, RN BACKGROUND: Physician level of service (LOS) is determined by Medicare documentation guidelines whereas an acuity based system for facility billing was recently validated (OWM January 2007). The purpose of this project was to determine the distribution of physician charges in outpatient wound centers and assess their relationship to a facility LOS. METHODS: 16 outpatient wound centers using a wound center specific, Level 4 electronic health record (EHR)* agreed to participate in a research consortium. The EHR calculates physician LOS by analyzing documentation fields based on Medicare requirements. RESULTS: 81,142 outpatient visits were evaluated from 8/31/2001 to 11/24/2006. Physicians usually billed initial visits at level 4 whereas facilities at Level 5. The majority of follow up visits for physicians were almost evenly distributed between level 2 and level 3 whereas for facilities, follow-up visits were level 4. CONCLUSION: There was a relatively good correlation between physician and facility LOS for initial visits but not for follow up visits. For follow up visits, ICD9 code had a significant impact on level of service although this was not true for initial visits. *Intellicure, Inc |
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