January 13, 2025 Release Notes

With this January release, we have added the Billing Ordering Practitioner to the following analyses:

• SPL Daily Resource (Facility only)

• SPL Resource (Facility and Peer)

• Resource Opportunity (Peer only)

• Custom Query

Note: Billing Ordering Practitioner in Custom Query will only return data when used with Resource related metrics because of how the data is collected. No data is returned for metrics that are not tied to a patient's billing data.

The Billing Ordering Practitioner is defined as the practitioner that ordered a service (at the charge code level) for a patient. This can be provided for every patient and corresponding charge code that is present in the billing data.

Notes:

• The Billing Ordering Practitioner is an existing optional field in the data acquisition file. It is not a required data element

• Billing Ordering Practitioner data will be available, where submitted, for discharges 10/1/2019 and forward

• The Billing Ordering Practitioner can be submitted for both Inpatients and Outpatients

• Multiple ordering practitioners can be submitted for the same patient, but only one ordering practitioner can be submitted per charge code line item

• Drilling on the Billing Ordering Practitioner is available

• You can use the Billing Ordering Practitioner when creating Custom Groups

Comparing Billing Ordering Practitioner and CPT Ordering Practitioner

CPT Ordering and Procedure Practitioners were previously added to QualityAdvisor. However, these were available for reporting on Outpatients only.

The Billing Ordering Practitioner is available for reporting on both Inpatients and Outpatients, but only when used with Resource related metrics because of how the data is collected. No data is returned for metrics that are not tied to a patient's billing data..

Type	Includes	Excludes
Billing Ordering Practitioner	Inpatients and outpatients submitted at the charge code level, regardless of if a CPT is present or not.	Inpatients and outpatients where an ordering practitioner is not submitted for a charge code.
CPT Ordering Practitioner	Outpatients where a CPT code is submitted. This can include CPTs submitted in the CPT file or CPTs from billing file (if profiled within Data Acquisition tools to pull billing CPTs on CPT table used for reporting).	Inpatients and outpatients where a CPT code is not submitted.