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Neurosurgery Billing and Reimbursement in 2021
Journal article   Peer reviewed

Neurosurgery Billing and Reimbursement in 2021

Richard Menger, Brett Youngerman, Rimal Hanif Dossani, Jakub Godzik, Steven Tenny, Jeffrey Cozzens, Nitin Agarwal, Bharat Guthikonda, Kristopher T. Kimmell, Clemens Schirmer, …
World neurosurgery, Vol.151, pp.348-352
07/2021
PMID: 34243668

Abstract

Billing CPT codes ICD-10 codes Medicaid Medicare Reimbursement
Practicing neurosurgery in 2021 requires a detailed knowledge of the vocabulary and mechanisms for coding and reimbursement, which should include general knowledge at the global level and fluency at the provider level. It is specifically of interest for the neurosurgeon to understand conceptually the nuances of hospital reimbursement. That knowledge is especially germane as more neurosurgeons become hospital employees. Here we provide an overview of the mechanics of coding. We illustrate the formula to generate physician reimbursement through the current relative value unit structure. We also seek to explain hospital-level reimbursement through the diagnosis-related group structure. Finally, we expand about different and ancillary income streams available to neurosurgeons and provide a realistic assessment including the opportunities and challenges of those entities.

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