CONTEMPLATING HEALTH ECONOMICS, CODING AND REIMBURSEMENT IN ORTHOTICS, PROSTHETICS AND PEDORTHICS
Open Access
- 21 September 2021
- journal article
- Published by University of Toronto Libraries - UOTL in CANADIAN PROSTHETICS & ORTHOTICS JOURNAL
- Vol. 4 (2)
- https://doi.org/10.33137/cpoj.v4i2.36125
Abstract
Reimbursement to U.S. healthcare service providers is largely transitioning from fee for service to fee for value for those clinicians who code using current procedural terminology and through their coding, describe their professional services. The Orthotic, Prosthetic and Pedorthic profession (O&P), currently codes using a system that describes the devices they evaluate for, fabricate, fit and maintain and their professional services are incorporated into their codes. These O&P codes, in contrast to those for other healthcare disciplines, are predominantly product based rather than service based, focusing on product features and function more than clinical service. This editorial manuscript provides a brief overview of the system the US O&P profession uses currently, particularly in the context of other healthcare professions transitioning to value based coding and reimbursement and culminates in a call to action for the profession to academically consider the strengths and weaknesses of the current system relative to alternative systems. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/36125/28316 How To Cite: Highsmith MJ, Fantini CM, Smith DG. Contemplating health economics, coding and reimbursement in orthotics, prosthetics and pedorthics. Canadian Prosthetics & Orthotics Journal. 2021; Volume 4, Issue 2, No.5. https://doi.org/10.33137/cpoj.v4i2.36125 Corresponding Author: M. Jason Highsmith, PhD, DPT, CP, FAAOP School of Physical Therapy & Rehabilitation Sciences, Morsani College of Medicine, University of South Florida. Florida, USA. E-Mail: mhighsmi@usf.edu ORCID ID: https://orcid.org/0000-0001-8361-7345Keywords
This publication has 27 references indexed in Scilit:
- Current procedural terminology; a primerJournal of NeuroInterventional Surgery, 2014
- The United States' health care system: Problems and solutionsSurvey of Ophthalmology, 1993
- Results and Impacts of the Resource-Based Relative Value ScaleMedical Care, 1992
- An Overview of the Development and Refinement of the Resource-Based Relative Value Scale The Foundation for Reform of U.S. Physician PaymentMedical Care, 1992
- Refinement and expansion of the Harvard Resource-Based Relative Value Scale: the second phase.American Journal of Public Health, 1990
- Paying physicians according to their resource-costs: The development of a Resource-Based Relative Value ScaleHealth Policy, 1989
- Results, potential effects, and implementation issues of the Resource-Based Relative Value ScaleJAMA, 1988
- Resource-based relative values. An overviewJAMA, 1988
- Results and Policy Implications of the Resource-Based Relative-Value StudyThe New England Journal of Medicine, 1988
- Estimating Physicians' Work for a Resource-Based Relative-Value ScaleThe New England Journal of Medicine, 1988