Abstract：
BACKGROUND: Current Procedural Terminology (CPT) codes provide a uniform language for medical billing, but specific codes have not been assigned for lymphatic reconstruction techniques. The authors hypothesized that inadequate codes would contribute to heterogeneous coding practices and reimbursement challenges, ultimately limiting surgeons\' ability to treat patients.
METHODS: A 22-item virtual questionnaire was offered to 959 members of the American Society of Reconstructive Microsurgeons to assess the volume of lymphatic reconstruction procedures performed, CPT codes used for each procedure, and challenges related to coding and providing care.
RESULTS: The survey was completed by 66 board-certified/board-eligible plastic surgeons (6.9%), who unanimously agreed that lymphatic surgery is integral to cancer care, with 86.4% indicating that immediate lymphatic reconstruction should be offered after lymphadenectomy. Most performed lymphovenous bypass, immediate lymphatic reconstruction, liposuction, and vascularized lymph node transfer.Respondents reported that available CPT codes failed to reflect procedural scope. A wide variety of CPT codes was used to report each type of procedure. Insurance coverage problems led to 69.7% of respondents forgoing operations and 32% reducing treatment offerings. Insurance coverage and CPT codes were identified as significant barriers to care by 98.5% and 95.5% of respondents, respectively.
CONCLUSIONS: Respondents unanimously agreed on the importance of lymphatic reconstruction in cancer care, and most identified inadequate CPT codes as causing billing issues, which hindered their ability to offer surgical treatment. Appropriate and specific CPT codes are necessary to ensure accuracy and consistency of reporting and ultimately to improve patient access to care.
METHODS: A 22-item virtual questionnaire was offered to 959 members of the American Society of Reconstructive Microsurgeons to assess the volume of lymphatic reconstruction procedures performed, CPT codes used for each procedure, and challenges related to coding and providing care.
RESULTS: The survey was completed by 66 board-certified/board-eligible plastic surgeons (6.9%), who unanimously agreed that lymphatic surgery is integral to cancer care, with 86.4% indicating that immediate lymphatic reconstruction should be offered after lymphadenectomy. Most performed lymphovenous bypass, immediate lymphatic reconstruction, liposuction, and vascularized lymph node transfer.Respondents reported that available CPT codes failed to reflect procedural scope. A wide variety of CPT codes was used to report each type of procedure. Insurance coverage problems led to 69.7% of respondents forgoing operations and 32% reducing treatment offerings. Insurance coverage and CPT codes were identified as significant barriers to care by 98.5% and 95.5% of respondents, respectively.
CONCLUSIONS: Respondents unanimously agreed on the importance of lymphatic reconstruction in cancer care, and most identified inadequate CPT codes as causing billing issues, which hindered their ability to offer surgical treatment. Appropriate and specific CPT codes are necessary to ensure accuracy and consistency of reporting and ultimately to improve patient access to care.
摘要：
背景：当前的程序术语（CPT）代码为医疗计费提供了统一的语言，但是尚未为淋巴重建技术指定特定的代码。作者假设代码不足会导致不同的编码实践和报销挑战，最终限制了外科医生治疗患者的能力。
方法：向美国重建显微外科医师协会的959名成员提供了22项虚拟问卷，以评估进行的淋巴重建手术的体积，用于每个程序的CPT代码，以及与编码和提供护理相关的挑战。
结果：调查由66名经董事会认证/符合董事会资格的整形外科医生（6.9％）完成，他一致认为淋巴手术是癌症治疗不可或缺的一部分，86.4%的患者表示淋巴结清扫术后应立即进行淋巴重建。大多数进行了淋巴静脉搭桥，立即进行淋巴重建,吸脂术,血管化淋巴结转移.受访者报告说，可用的CPT代码未能反映程序范围。使用各种各样的CPT代码来报告每种类型的程序。保险范围问题导致69.7％的受访者放弃运营，32％的受访者减少了治疗服务。98.5%和95.5%的受访者认为保险范围和CPT代码是护理的重大障碍，分别。
结论：受访者一致同意淋巴重建在癌症治疗中的重要性，以及大多数确定的CPT代码不足导致计费问题，这阻碍了他们提供手术治疗的能力。适当和具体的CPT代码是必要的，以确保报告的准确性和一致性，并最终改善患者获得护理的机会。
方法：向美国重建显微外科医师协会的959名成员提供了22项虚拟问卷，以评估进行的淋巴重建手术的体积，用于每个程序的CPT代码，以及与编码和提供护理相关的挑战。
结果：调查由66名经董事会认证/符合董事会资格的整形外科医生（6.9％）完成，他一致认为淋巴手术是癌症治疗不可或缺的一部分，86.4%的患者表示淋巴结清扫术后应立即进行淋巴重建。大多数进行了淋巴静脉搭桥，立即进行淋巴重建,吸脂术,血管化淋巴结转移.受访者报告说，可用的CPT代码未能反映程序范围。使用各种各样的CPT代码来报告每种类型的程序。保险范围问题导致69.7％的受访者放弃运营，32％的受访者减少了治疗服务。98.5%和95.5%的受访者认为保险范围和CPT代码是护理的重大障碍，分别。
结论：受访者一致同意淋巴重建在癌症治疗中的重要性，以及大多数确定的CPT代码不足导致计费问题，这阻碍了他们提供手术治疗的能力。适当和具体的CPT代码是必要的，以确保报告的准确性和一致性，并最终改善患者获得护理的机会。
