How improvements in vascular surgery coding are vital in the assessment of American vascular surgeon readiness to deliver care in current and future warfare

Background: The military uses the civilian coding structure of Current Procedural Terminology (CPT) codes and relative value units (RVUs) to measure resource need and provider productivity. The Knowledge, Skills, and Abilities (KSA) methodology uses garrison CPT codes to assess surgeon readiness to deliver battlefield care. Our primary objective was to determine if implementing specialty-trained coding teams affected procedural CPT code capture and surgeon readiness calculations. The secondary goal was to analyze changes in work RVUs after the intervention. Methods: Data were queried from vascular surgery and neurosurgery claims records at a single institution for fiscal years 2017 (before the intervention) and 2019 (after the intervention) to analyze changes in CPT code capture. A specialty-trained coding team consisting of a surgeon, coder, and auditor attended specialty-specific coding courses during the intervention period. The vascular surgery team attended the Society for Vascular Surgery's annual coding course. Results: After the intervention, there was an increase in CPT code capture and provider productivity (RVUs) in both specialties. The impact on vascular surgeon readiness using the KSA methodology demonstrated little change in procedure volume but increased KSA score. Conclusions: The studied coding system improvement resulted in a more accurate reflection of surgical readiness (KSA scores) and increased RVUs. Proper coding is the foundation for leadership decision support for investments in military medicine and optimizing surgeon readiness assessments.