{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:19:19Z","timestamp":1786123159529,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transplant infectious diseases (TID) clinicians provide complex, high\u2010acuity cognitive care that is frequently undervalued due to inconsistent documentation and underutilization of appropriate evaluation and management (E\/M) and billing codes. Limited published data describe billing practices or educational approaches within TID. We evaluated a documentation and coding education model aimed at improving billing accuracy and recognition of TID clinical complexity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective analysis of administrative billing data from a tertiary\u2010care academic institution (Medical University of South Carolina) before and after implementation of a structured documentation and billing education initiative (FY 2022\u20132025). The intervention included division\u2010wide didactic sessions, onboarding training for fellows and faculty, and standardized note template documentation. Outcomes included E\/M level distribution for initial and subsequent visits, utilization of G0545 codes, 2025 CMS reimbursement rates, and use of critical care billing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Following the intervention, high\u2010complexity documentation and billing improved substantially. Level 3 initial consults increased from 40% (2022) to 69% (2025), and Level 3 subsequent visits demonstrated a 36% absolute increase. Overall RVU generation increased by 11.8% during the period. G0545 utilization improved but remained inconsistent. Critical care billing showed slow adoption, largely related to perceived documentation burden and limited familiarity with time\u2010based requirements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Even a low\u2010intensity documentation and coding education model produced sustained improvement in high\u2010complexity billing within a TID program. Infectious disease\u2010specific codes and critical care billing represent important, underutilized revenue opportunities nationally. Standardized education and workflows may be essential to financial sustainability and workforce support in TID.\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid70238-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tid.70238","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T13:40:48Z","timestamp":1778593248000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Documenting Clinical Complexity: A Model for Improving Documentation and Billing in Transplant Infectious Diseases"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4611-0670","authenticated-orcid":false,"given":"Courtney E.","family":"Harris","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassandra","family":"Salgado","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Sublett","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3916-4021","authenticated-orcid":false,"given":"John E.","family":"McKinnon","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/mot.0000000000001105"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.70060"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad416"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaf756"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0009922809337622"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12960\u2010021\u201000631\u2010x"},{"key":"e_1_2_10_8_1","unstructured":"\u201cCoding and Payment \u201dIDSA accessed February 19 2026 https:\/\/www.idsociety.org\/practice\u2010resources\/practice\u2010tools\/coding\u2010and\u2010payment."},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaf695.2269"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/piaf033"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.41521"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2025.05.016"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajmo.2025.100104"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhm.70142"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2024\u2010008183"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000000983"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2021.06.027"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2025\u2010008502"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaf695.1754"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit610"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.24148"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsurg.2016.08.011"}],"container-title":["Transplant 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