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wrvu

J

jraciti@specbill.com

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Yorktown Heights, NY
What is the standard industry for applying WRVUs for bilateral injections 150% x 1 unit or 100% x 2 units? Or just the WRVU 100% for one unit?
 
Work RVUs are assigned per each instance of CPT code, however CPT codes reported with billing modifiers may have differing adjustments. There's no clear guidance that I'm aware of because CMS assigns the work RVUs, each provider's employment contract can be different (from a WRVU bonus perspective) and each payer contract may reimburse differently.

For example, CPT 20610 (major joint injection) has 0.77 work RVUs. When injected bilaterally, you can calculate work rvus as 1.54 (2 injections), or 1.15 work RVUs (150%). While some payers might pay the allowable for two injections, others may pay only 150%. You have to run an analysis to determine which is more feasible for your organization. This is the same rationale for all billing modifiers that might impact reimbursement (and of course, work RVUs).
 
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