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Practice Management Alert

Reader Question:

Base Billing Order on RVU Order

Published on Thu Jan 13, 2011

Question: I know that as a general rule the highest RVU has a higher billed amount and that when you bill you should always put the highest amount first. But when it comes to bilateral surgeries is it true that you would sometimes be prudent to put another procedure first because a bilateral code that was done bilateral/unilateral would still be paid at a reduced allowable? Texas SubscriberAnswer:  Yes, you should sometimes put another procedure first. If the 150 percent amount of the relative value units (RVUs) for a bilateral procedure is the highest, you should put that code first. Here's why: Because the insurer will discount the second and subsequent procedures based on multiple procedure discounts, it's best to list the codes in RVU order, with the highest-paying code listed first. Keep in mind that you should follow this rule of thumb even if your insurer requires you to [...]
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