Current Procedural Terminology (CPT) coded services provided by nurse specialists.
In this exploratory study, a random sample of nurses from nine nursing specialties was surveyed to identify which Current Procedural Terminology (CPT) coded procedures they perform and how frequently they perform them. CPT codes are used universally to file claims for physician payment. The sample included 74 school nurses, 67 enterostomal nurses, 53 family nurse practitioners, 43 critical care nurses, 43 oncology nurses, 40 rehabilitation nurses, 39 orthopaedic nurses, 34 nephrology nurses and 25 nurse-midwives. Specific questionnaires were developed for each specialty with codes identified by expert panels. The number of CPT codes ranged from 233 for family nurse practitioners to 58 for school nurses. The mean number of coded services performed by individual respondents ranged from 79 (FNP) to 18 (school nurses); individual respondents performed 0-162 codes. Supervision by physicians was very infrequent. Charges to Medicare in 1988 for the coded services included in the survey were $22,793,427.34 (aggregate allowable charges). The study provides some documentation of the degree to which nurses perform the same services and procedures for which physicians are being paid. If policy makers are serious about reaching innovative solutions to the problems of quality, access and cost, everything must be "on the table," including the contributions of nurses.
Griffith
H M
HM
Office of Disease Prevention and Health Promotion, U.S. Public Health Service, Fargo, ND.
Robinson
K R
KR
D000043:Abstracting and Indexing; D000328:Adult; D005245:Fee Schedules; D005260:Female; D018166:Health Care Reform; D006801:Humans; D008297:Male; D008499:Medical Records / Q000145:classification*; D006278:Medicare / Q000706:statistics & numerical data*; D008875:Middle Aged; D009398:Nephrology / Q000145:classification / Q000191:economics; D009739:Nursing Services / Q000145:classification* / Q000191:economics / Q000706:statistics & numerical data; D016530:Orthopedic Nursing / Q000145:classification / Q000191:economics; D012046:Rehabilitation / Q000145:classification / Q000191:economics; D012051:Reimbursement Mechanisms; D013041:Specialties, Nursing / Q000191:economics* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014481:United States