Work for a dollar get reimbursed a dime, an analysis of the dire need for coders trained in vascular billing
Luke D Perry1, Lori D Pounds1, Reshma D Brahmbhatt1, Alissa Hart2
1UT Health San Antonio, San Antonio, TX;2Audie Murphy VA Medical Center, San Antonio, TX
The field of vascular surgery both open and endovascular is becoming ever more complex as new technologies and innovations are rolled out. This complexity is mirrored in its billing and coding. Current procedural terminology (CPT) codes are assigned to operations and additions which are given relative value units (RVU) allowing for a physician to determine productivity and ultimately pay. As the complexity of vascular surgery increases so does its coding making vascular billing a subspecialty in its self. The purpose of this study is to show the dire need for coders trained in vascular billing.
This is a retrospective study of a vascular surgery group from January 2019 to August 2023 at a government run hospital. The study captures all TCARS, EVARS, and FEVARs analyzing the total number of cases, the number coded correctly, the total number of RVUs, and the number of RVUs actually captured.
A total of 66 total procedures were completed, 28 coded correctly. CPT codes used for TCAR 38215 and 37215, EVAR 34705, and FEVAR 2 fenestrations 34842. 14 TCARs were completed (total RVU 251.36) with 14 coded correctly (RVU captured 248.5). 51 EVARs were completed (total RVU 1484.92) with only 17 coded correctly (RVUs captured 941.33). 1 FEVAR was completed (total RVU 31) with 0 coded correctly (RVUs captured 4.13). Total RVUs completed were 1764.42 while only capturing 1196.82.
Vascular trained coders are a must for any institution with vascular surgery. The results here are only involving three operations with basic coding and only 42% coded correctly with 67% of the RVUs being captured. This a staggeringly low number raising great concern for other procedures performed that have more complex coding and modifiers. RVUs are incredibly important and should matter to any physician as not only do they guide reimbursement but also show their institution their worth via productivity.
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