Urology Coding Alert

Urologists break even as work RVUs are cut and conversion factor increases

CMS offered urologists an early holiday gift this year. Despite earlier reports of a 4.5 percent conversion-factor decrease, CMS announced a last-minute increase, raising the conversion factor by 1.5 percent for 2004 and 2005.
 
Thanks to the Medicare Prescription Drug and Improvement Act, approved by Congress on Nov. 25, 2003, and signed into law by the president on Dec. 8, 2003, the conversion factor, which was $36.7856 in 2003, will rise to $37.3374 in 2004.
 
This projected increase in the conversion factor is particularly good news for urologists because CMS did not increase relative value units (RVUs) for most urology procedures. In fact, Medicare decreased the work RVUs for many services (see chart below) and did not change the RVUs for most others. The chart lists some sample work RVU cuts that will affect urology practices.

But because of the increase in the conversion factor, an increase in the practice-expense RVUs in many cases, and an across-the-board increase in the malpractice RVUs, many decreases in fees will be only 1 percent to 2 percent. In fact, some of the above procedures, such as 50541, 50546 and 52601, will enjoy small fee increases for 2004.