Nurses' critical role in CPT code valuation

Abstract

:Relative value units (RVUs) are a measurement of practice efficiency and patient complexity. RVUs are reviewed by the Centers for Medicare and Medicaid Services through the Resource-Based Relative-Value Scale Update Committee, which determines recommendations regarding the Current Procedural Terminology code valuations for the Medicare Physician Fee Schedule. This article discusses the importance of nurses' participation in the accurate valuation of their work and in the process of developing and revising RVUs.

The NP's role in increasing RVU values

“…CPT codes are used to describe tests, surgeries, evaluations, and any other medical procedures performed by healthcare providers. 5 An understanding of the reimbursement system is key for survival in today's healthcare environment, as erroneous coding may result in a substantial loss of revenue or imposition of monetary penalties. 6 NPs already contend with disproportionately lower reimbursement.…”

“…7 ■ RVUs RVUs are a measurement of practice effi ciency and patient complexity. 5 An RVU has three components: provider's work, practice expense, and professional liability insurance expense. 8,9 For example, an NP's work RVUs include clinical skills and time needed to treat a patient during an encounter.…”

“…RVUs are a measurement of practice efficiency and patient complexity 5. An RVU has three components: provider's work, practice expense, and professional liability insurance expense 8,9.…”

“…An RVU has three components: provider's work, practice expense, and professional liability insurance expense 8,9. For example, an NP's work RVUs include clinical skills and time needed to treat a patient during an encounter 5. Practice expense RVUs consist of the practice's overhead, such as the expenses for building space, equipment, office supplies, and clinical staff time (such as the work of licensed practical nurses and RNs) 2.…”

“…8,9 For example, an NP's work RVUs include clinical skills and time needed to treat a patient during an encounter. 5 Practice expense RVUs consist of the practice's overhead, such as the expenses for building space, equipment, offi ce supplies, and clinical staff time (such as the work of licensed practical nurses and RNs). 2 Professional liability insurance expense RVU comprises the cost of malpractice insurance premiums.…”