This episode of the BackTable OBGYN podcast features Dr. Barbara Levy, an OBGYN and seasoned expert in medical coding and reimbursement, discussing the nuances of medical billing, the process of creating medical codes, and how medical practices and expenses are valued differently.

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SYNPOSIS

Key topics from this episode include the impact of indirect practice expenses, the role of different organizations in surveying costs and implementing new codes, the importance of coding for procedure reimbursement, and a task force’s findings on gender disparities in coding. The conversation transitions into the practical implications of where procedures are performed (office vs. surgical center vs. hospital) and how this impacts payment and patient costs. Dr. Levy emphasizes the efficiency and patient benefits of office-based procedures, exemplified by the Cerene cryotherapy ablation device. The complexities of the reimbursement system, including work Relative Value Units (RVUs), facility fees, and the push towards bundling services, are unpacked. The episode underscores the importance of understanding healthcare economics to advocate effectively for patient care improvements.

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TIMESTAMPS

00:00 - Introduction02:24 - History of Medical Coding11:32 - The Process of Medical Code Creation21:15 - Understanding RVUs and Practice Expenses26:35 - Challenges of Accurately Valuing Procedures32:05 - Changing Codes/Reimbursement: Endometriosis Example36:06 - The Art and Science of Medical Coding39:26 - Site of Service and Facility Fees51:15 - Benefits of Outpatient Procedures55:46 - Example: Cerene Cryoablation58:14 - Addressing Gender Disparities in Medical Reimbursement

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RESOURCES

ACOG Resources on Coding and Billing:https://www.acog.org/practice-management/coding