DRG Coding Advisor-Effect of new RVUs on selected procedures
Here are some of the codes affected
The table on p. 25 shows the percentage shift in total payment (in year 2000 physician fee schedule dollars) for selected high-volume procedures resulting from the Health Care Financing Administration's (HCFA) new rules for practice expense and malpractice relative value units (RVUs). It also shows the effect on whether the procedure is performed in an office or facility setting once the final RVUs are fully implemented in 2002.
In general, HCFA says payments for services in the facility setting, including evaluation and management services, are declining due to its policy to exclude costs associated with bringing clinical staff to the facility setting. Payment for a tissue exam by a pathologist (CPT 88305) is increasing due to HCFA's proposal to remove the service from the zero work pool. The increase in value for the technical portion of the services causes a corresponding increase in the global service.
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