READER QUESTIONS:
Stick With the Correct Code, Not RVU
Published on Thu Jul 23, 2009
Question: My physician wonders why +63044 does not have any relative value units (RVUs); he thought it actually had a higher RVU value because of the additional work involved with performing a re-exploration. Can you help me explain this to him? Virginia Subscriber Answer: According to CMS guidelines, code +63044 (Laminotomy [hemilaminectomy], with decompression of nerve root[s], including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploadminister ration, single interspace; each additional lumbar interspace [List separately in addition to code for primary procedure]) carries a payment status indicator of C. That means you're reporting an inpatient procedure that's not payable by the Outpatient Prospective Payment System (OPPS). Your carriers will "price" these procedures and their RVUs. Comparison time: +63044 doesn't have RVUs, but some add-on codes for similar procedures do. Because of this, physicians might be tempted to report 63047 (Laminectomy, facetectomy and foraminotomy unilateral or bilateral with decompression [...]
