Medicare Compliance & Reimbursement

Skin debridement, hip arthroplasty may be money losers next year

Get ready: Work relative value units (RVUs) could drop more than 10 percent for some codes.
 
Of the 709 codes which the Centers for Medicare & Medicaid Services (CMS) referred to the Relative Value Update Committee (RUC) for review, most either increased or stayed the same. Because of the 10-percent across-the-board cut in work RVUs, which CMS plans for 2007, any code that didn't increase its work RVUs effectively takes a pay cut.
 
Skin debridement codes 11040-11042 will see their work RVUs drop around 25 percent, though specialty societies had requested an increase.
 
Facial lesion excision codes 11641-11642 will face similar shortfalls. Lesion destruction codes 17003-17004 will drop, with 17003 nearly halved.
 
Neck spine fusion code 22554 will drop slightly. But 27130 (Total hip arthroplasty) will drop from 20.09 to 15.96, 27236 (Treat thigh fracture) drops from 15.58 to 12.77, and 27447 (Total knee arthroplasty) drops from 21.45 to 19.30. In all three cases, CMS disagreed with the RUC's recommendations for those codes. By contrast, 29580 (Application of paste boot) will drop in spite of a requested increase.
 
Also facing drops in 2007 are tongue biopsy code 41100, bladder lesion treatment code 51720, simple brain aneurysm repair code 61700, laminectomy code 63047, diskectomy code 63075, cataract surgery code 66984, photodynamic therapy code 67221 and myocardial perfusion study codes 78478-78480.