Wiki Listing CPT codes according to RVU

mray85

Networker
Messages
94
Location
Richardson, TX
Best answers
0
Hello. I am having difficulty with a topic in the physician group I code for. I am trying to find some information regarding listing CPT codes on a HCFA according to RVU amounts. I remember in my training book from AAPC that we list highest RVU on the claim first, followed by lesser values. Is there some guidelines set by CMS somewhere for this? Something that I can print and present to the physicians?
Thanks!
Matthew Sibley, CPC
 
Maybe this will be helpful. Page 112 (thereabouts)

Rank the surgeries subject to the standard multiple surgery rules (indicator ?1?) in descending order by the Medicare fee schedule amount;

7. Base payment for each ranked procedure on the lower of the billed amount, or:

100 percent of the fee schedule amount (Field 34 or 35) for the highest valued procedure;
50 percent of the fee schedule amount for the second highest valued procedure; and
25 percent of the fee schedule amount for the third through the fifth highest valued procedures;

http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c12.pdf
 
Top