RVUs (relative value units) cause a lot of confusion in the medical billing world when you're dealing with imaging procedures. It's really just a matter of listing your services rendered logically then tallying them up from largest to smallest. For example, imaging codes aren't discounted under the multiple-surgery payment reduction, so you typically list surgical codes first, in order by RVU, then the imaging codes.

Your final coding report should look like this in order :

* 35471 main coding

* 36245 main coding

* 75722-26-59 procedure with modifier

* 75966-26. procedure with modifier

Just remember to list the "heavier" codes at the top of your list and the lighter codes such as imaging, at the bottom. You should include a diagnosis code where appropriate that is based on what the radiologist documents. Tie this in with what the treating physician documents and you should have a specific diagnosis for the patient to show exactly what the RVUs are that you are billing for.

Make sure that your medical billing has the necessary documentation to get the best reimbursements possible. Your documentation showing medical necessity for any service you're looking for reimbursement for should be clear to the carrier or you risk partial payments or outright denials on your medical billing claim.

Labels: audit, claims, medical-billing, medical-coding, modifiers, outsourcing