A CMS coding change in 2023 is associated with surgeons in Michigan documenting larger hernias.
for the repair of anterior abdominal hernia s that are ≥ 3 cm, the percentage of hernias documented as smaller than that threshold decreased from 60% to 49.3%, data from Michigan showed.Researchers analyzed cases from a clinical hernia registry representing nearly 90% of hospitals in Michigan .
The analysis included 9387 ventral and incisional hernia repairs performed between January 1, 2022, and December 31, 2023; 49.9% of the repairs occurred before the rate change in 2023, and 50.1% occurred after the new payment took effect. Patients were an average age of about 55 years, and 43.3% were women. Patients treated before the coding change and those treated after did not significantly differ by age, sex, race, insurance status, surgical approach, or rate of hernia incarceration.Before the coding change, 60% of hernias were smaller than 3 cm compared with 49.
Alternatively, “the coding change may have induced surgeons to overestimate hernia size, either consciously or unconsciously,” they reported. “Ambiguous tasks, such as measuring hernia size, can be conducive to perceptive bias and potentially even dishonest behavior, perhaps more so with financial incentives at play.”Dana A. Telem, MD, MPH, with the University of Michigan in Ann Arbor, was the corresponding author for the study.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.All material on this website is protected by copyright, Copyright © 1994-2025 by WebMD LLC. This website also contains material copyrighted by 3rd parties.
Michigan Financial Reimbursement Reimbursement Practice Management Revenue Abdominal Wall Hernia Abdominal Hernia Abdominal Artificial Intelligence Deep Learning AI NPL Machine Learning ML Natural Language Processing Artificial Neural Networks Grant Hernia Repair Hospitals Incisional Hernia Insurance Kidneys Medicaid Medicare
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