# RVU order when doing charge entry



## DebbiePottsEngland (Aug 1, 2008)

I am needing some help with figuring out how to get our charge entry department to put procedures in RVU order.  Should all the procedures on the superbill be listed in RVU order? or does it matter?
Any help would be appreciated.
Debbiep


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## Treetoad (Aug 1, 2008)

I've been taught to charge all services in RVU order.  That was also confirmed at several of the workshops I've attended.


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## FTessaBartels (Aug 1, 2008)

*Superbill order*

Well, Debbie, I agree that you need to get your billing / charge entry people to list in RVU order (highest first), with appropriate modifiers.

I'm not sure listing items on your superbill in this order will necessarily help, or that your providers will like that design (they are the ones filling it out, after all). 

Most superbills I've seen (and helped design) are organized by like procedures:
All E&M grouped together, then all procedures listed either in alpha order, or in order of usual frequency for that specialty/office.

I admit I've never considered listing things on the superbill in descending RVU order. 

Let us know what you decide and how it works out.
F Tessa Bartels, CPC


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## LCRUZ515 (Aug 16, 2008)

Debbie it really dosn't matter. We had this question come up recently at the company I work for. My supervisor insisted that we enter the highest paying procedure first. Some of us questioned this method. We questioned why would we enter a complex repair before we entered the excision, which is why the repair was being made in the first place. We came to the conclusion that the insurance takes the muliple surgery reduction on the lowest paying rvu any ways. We also came to the conclusion that coding should be based on proper guidlines rather than payment. 

So my answer to you is if you are concerned in the order because of the reimbursment it does not make a difference.

Hope this helped you


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## rigdon72 (Jun 2, 2010)

*RVU Order - does it REALLY matter?  Prove it please.*

Is there an official current document I can reference supporting one way or the other?  We are having this debate in our organization.  I remember many years ago (??15 yrs??) it was required by some carriers in order to properly calculate the reimbursement (100%-50%-50%, etc).  But surely with the advancement of technology this rule doesn't apply anymore.  Also, whose to say that the order doesn't get switched around once it hits the carrier anyway?  I worked for a carrier many years ago (??12 yrs??) processing payments, and even back then we re-ordered the CPTs many times anyway.  It didn't matter what order they were submitted or entered into the system, the computer calculated the payment: 100% based on the highest RVU, even if the highest RVU was line #5, we paid 100% for line #5 and 50% for all the remaining.


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## kasmithortho (Oct 10, 2011)

*RVU order matters to our charge entry software.*

Hi,

I have been doing coding and billing for over 20 years and I was taught to always put the highest RVU service first. I always worked in doctors offices and now work in a large hospital system with their outpatient physcian practices and it does matter for us as our billing software automatically does the contractual write off at charge entry. If the charges are not entered in the proper RVU order it makes a major impact to reimbursement because it does the adjustments by our contractual  payer contracts.

Karen Smith, CPC


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