William R. Beach, MD has stepped down as chairman of the Health Policy and Practice Committee and I think we all owe him a great deal of gratitude for the great job he has done over the past several years. Bill has worked tirelessly on our behalf in the arena of reimbursement and his efforts have added great value to our practices. Thanks Bill! I have taken over as chairman and would like to report on our efforts over the past several months. We have been to the RBRVS Update Committee, or RUC, for two issues.
First, we were asked to become part of an AAOS project that sought to clarify the CPT coding nomenclature for 52 fracture codes that included the description, "with or without internal or external fixation." Since the two modes of fixation are rarely used concomitantly, the Academy felt that the descriptors were redundant and misleading. The AAOS petitioned the CPT Editorial Committee to change the descriptors and were told that doing so would require a complete re-evaluation of all the codes and a RUC review. The AAOS then convened a panel of experts to facilitate the re-evaluation and asked AANA to spearhead the review of 11 shoulder and elbow codes in this group. RUC surveys were e-mailed to AANA members; thanks to all who took the time to fill them out! When all the surveys were completed, we met with members of the Orthopedic Trauma Association, the Foot and Ankle Society and the Hand Society to choose new CPT RVU values for all the codes. We then presented the 52 codes as a package in a relative rank order to the RUC in San Diego in February. The results are in the table below. The AAOS considered the project a success as most of the codes received significant increases in RVU value.
The process underscored the value of having AANA members actively involved in the survey process. Over the next few years, many arthroscopic codes will be up for RUC review. If you get requests to fill RUC surveys on them, please do so! They are tedious at first but not too bad after the first one. The directions are included with the e-mails. Remember, the RVU values that procedures get are directly related to the amount of physician work time inherent in the pre-operative evaluation, intra-operative procedure, post-operative communication and evaluation and follow up office visits.
Second, we presented three new sets of CPT codes to the RUC earlier this month. The first is a new code 2982X for biceps tenodesis. The second is 2741X for open osteochondral autograft transplantation the last are a set of codes, 299X1-X4, for subtalar arthroscopy. Bill Beach made the presentation and the results are in Coding Corner.
Lastly, we have been involved in generating two position statements in conjunction with the AAOS. The first recognizes the Global Service Data book (GSD) as the definitive guide in orthopedic CPT coding. The second recognizes that all procedures with Category 1 CPT codes are medically necessary and not experimental.
