tci Medicare Compliance & Reimbursement - 2012 Issue 2

Reader Question: Get to Know Pecking Order for CPT® Codes

Question:I know that as a general rule the highest RVU has a higher billed amount and that when you bill you should always put the highest amount first. But when it comes to bilateral surgeries is it true that you would sometimes be prudent to put another procedure first because a bilateral code that was done bilateral/unilateral would still be paid at a reduced allowable?Answer: Yes, you should sometimes put another procedure first. If the 150 percent amount of the relative value units (RVUs) for a bilateral procedure is the highest, you should put that code first.Here's...

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