Have you ever wondered what your office visit mix is? What percentage of your total office visits are well visits? Is your office visit mix impacted by the season? What is your E&M distribution? In this post, we look at some examples of how to visualize the office visit mix for a pediatric practice.    

In a pediatric office, well visits rule. The following examples show a practice’s sick and well office visit distribution. The chart on top shows the distribution by provider, and you can quickly see which providers are doing most of the well visit work. In this example, the providers who have the higher percentage of sick visits are primarily used in the urgent care setting. The bottom chart displays the sick/well visit distribution by month.

Another way for practices to measure well visits is to use a ratio. The table below shows a practice’s well visit ratio, which is the total well visits divided by the total E&M visit.

In the above example, the data are grouped by month. However, you could easily group the data by location, payer, or provider. The chart below displays the ratios organized by provider.

Sometimes it’s helpful to look for seasonal impact on your visit mix. Looking at the graph below, you can see the well visit ratio trend over several years. It’s clear that the ratio peaks every August, which is typically when kids are getting ready to head back to school and need their physicals.

Many practices are interested in their E & M distribution, focusing on CPT codes 99212 through 99215. This information is especially helpful to organize by provider. You can quickly see if there are certain providers who are coding more 99214 and 99215 visits, which could potentially trigger an audit.

Keep in mind that this is a limited analysis that focuses on pediatric office visit CPT codes. With the right BI tools – such as Microsoft Power BI or Excel) – you can effectively measure any CPT code set that you wish.

Questions or Comments? Feel free to email me at medicalpracticeintel@outlook.com