A Quick Guide to Increasing Provider RVUs

RVUs, or Relative Value Units, are a measure of value used in the US Medicare Reimbursement Formula for Physician services.  RVUs are a part of the system Medicare uses to decide how much it will reimburse physicians for each of the services and procedures covered under its Physician Fee Schedule and which are assigned Current Procedural Terminology (CPT) Codes.

Most practices compensate their physicians using an RVU model which compensates based on the work performed rather than the number of patients seen since the level of work required varies patient to patient.

One contributing factor to the complexity of Emergency Medicine billing is that RVU’s are frequently impacted by the documentation of procedures.  Appropriate procedure documentation can make a big difference in RVU’s.

The following is a list of potential scenarios to illustrate the impact they can have:

  • Splint application: Long arm and both long and short leg splints have the RVUs roughly equal to CPT 99283. Documentation of physician review of splint placement can add RVUs quickly
  • Performing procedures typically done by ancillary staff. If a provider is inserting Foley catheters, NG tubes and IV access, make sure that is documented as done by ED provider.
A Quick Guide To Increasing Provider RVUs
  • Fracture care: Documentation requires the provider to state they provided definitive or restorative care. A complete procedure note will keep a chart from being sent back for an incomplete procedure note:
  • Documentation must give a complete and detailed description of the procedure.
  • Documentation for reduction of mandible dislocation:
      • Insufficient Documentation: “Closed reduction attempt was made after patient was medicated. Patient appears clinically reduced.”
      • Complete Documentation: Reduction done by applying downward pressure and pushing the mandible back over the articular eminence. Reduction successful.

6 Documentation Tips to Increase the Coding
of the Level

Here are some documentation tips that can help increase the coding of the level:

  • Co-morbidities that effect the medical decision making
  • Stable
  • Worsening
  • Communication with family members about medical decisions
  • Patient re-evaluations to determine response to treatment and interventions
  • Work up considered but not performed
  • Prescription drug management
  • Given in ED
  • Rx sent home
  • Change to current medication dosage
  • Condition of patient when admitted

If you are unsure about your current coding strategies, contact the team at DuvaSawko.  Our team can perform an in-depth analysis of your current billing and coding strategies to ensure optimal efficiency in all areas.  Call us at 888-311-8760 or visit us online at www.duvasawko.com.

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