Wiki Sequencing CPT codes based on RVUs

[gracerobin2004]

Specifically, surgery was scheduled for a bariatric procedure 43775 and the primary Dx code was E66.0 with a Z68.43. Second listed on the op report was repair of Hiatal Hernia 43281 and Dx K44.9. The RVU is higher for the hiatal hernia repair but it is not the primary reason for the surgery. Should the CPT code for the Hiatal Hernia repair be billed first and the ICD_10 code sequenced according to that or should the primary reason for the surgery be listed first corresponding to the supporting first listed Dx of Obesity? How will the multiple procedure rule for reimbursement be applied? Please help me understand the principle here Thanks everyone

 

[csperoni]

In my opinion, it is always a good idea to sequence your CPT high to low value. With automated claims processing systems, it should not matter, but by sequencing high to low, you are reducing the chance of a potential incorrect payment calculation.

 

[gracerobin2004]

In my opinion, it is always a good idea to sequence your CPT high to low value. With automated claims processing systems, it should not matter, but by sequencing high to low, you are reducing the chance of a potential incorrect payment calculation.

How should the ICD-10 codes be sequenced? Thanks for that information?

 

[csperoni]

How should the ICD-10 codes be sequenced? Thanks for that information?

ICD-10 should be sequenced with first diagnosis as the primary reason for the service. If there is a coding guideline to "code first" something else, then follow that coding guideline.
If there are multiple CPT and ICD-10, each ICD-10 should only be linked to the appropriate CPT.