Anyone else think its bogus our start up units are reimbursed based on the surgery itself?

[DrOwnage]

Anyone think its annoying that our base units are reimbursed based on the reimbursement of the surgery itself? Like we get 13 units for a ACDF, but 4 units for a prone leg stab phlebectomy, or a prone back mass excision. 5 units for a BiV ICD in a guy with an EF of 10%. Do you think billing codes will ever change to fit the risk of the procedure vs just the surgical compensation?

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[coffeebythelake]

Anyone think its annoying that our base units are reimbursed based on the reimbursement of the surgery itself? Like we get 13 units for a ACDF, but 4 units for a prone leg stab phlebectomy, or a prone back mass excision. 5 units for a BiV ICD in a guy with an EF of 10%. Do you think billing codes will ever change to fit the risk of the procedure vs just the surgical compensation?

Sure it isnt perfect but what else do you suggest? You dont agree with the specific scenarios? Extra units for ASA status, placement of blocks and advanced monitors...

 

[DrOwnage]

Wondering if its always been that way or it was streamlined for a reason. Like why can't we have modifiers? Patient is septic, unstable, transfusion required, BMI >35-40. Some stuff takes more planning, logistics and definitely more work we don't get reimbursed for.

 

[linkin06]

Wondering if its always been that way or it was streamlined for a reason. Like why can't we have modifiers? Patient is septic, unstable, transfusion required, BMI >35-40. Some stuff takes more planning, logistics and definitely more work we don't get reimbursed for.

You get more for asa 3-4 and E

 

[GassYous]

The real issue is what those units are worth. Should be going up every year due to inflation but instead gets continually cut.

 

[Lecithin5]

My plumber makes more to unclog a toilet than we get reimbursed to take care of a medicare VAD pt undergoing a GI procedure.

 

[DrOwnage]

You get more for asa 3-4 and E

I work PP and I've never got more for marking ASA 3 or 4 or even 5 for that matter.

 

[buddababa]

My plumber makes more to unclog a toilet than we get reimbursed to take care of a medicare VAD pt undergoing a GI procedure.

i hate this argument, i see it used all the time, heck i've even used it before. It holds no weight.

 

[coffeebythelake]

I work PP and I've never got more for marking ASA 3 or 4 or even 5 for that matter.

How about 6?

 

[GassYous]

I work PP and I've never got more for marking ASA 3 or 4 or even 5 for that matter.

3 = +1
4 = +2

Some groups grab those units to support the office

 

[vector2]

Anyone think its annoying that our base units are reimbursed based on the reimbursement of the surgery itself? Like we get 13 units for a ACDF, but 4 units for a prone leg stab phlebectomy, or a prone back mass excision. 5 units for a BiV ICD in a guy with an EF of 10%. Do you think billing codes will ever change to fit the risk of the procedure vs just the surgical compensation?

I think rather than change the base unit system, there just needs to be modifiers that actually pay fairly for the insane PITA things (like positioning) that can occur for simple cases, + the modifier for 3's and 4's needs to pay more as well.



Makes me wonder how much we got paid on the emergent'ish bleeding hemorrhoidectomy, Hgb 6, unknown malignancy, worsening constrictive pericarditis over the last couple years, and CRS insisting that it had to be prone....

 

[GassYous]

I think rather than change the base unit system, there just needs to be modifiers that actually pay fairly for the insane PITA things (like positioning) that can occur for simple cases, + the modifier for 3's and 4's needs to pay more as well.



Makes me wonder how much we got paid on the emergent'ish bleeding hemorrhoidectomy, Hgb 6, unknown malignancy, worsening constrictive pericarditis over the last couple years, and CRS insisting that it had to be prone....

Probably around 13 units

 

[brominator]

i hate this argument, i see it used all the time, heck i've even used it before. It holds no weight.

Why sell yourself short, it’s a great argument. Not to put down plumbers at all.

 

[kidthor]

Why sell yourself short, it’s a great argument. Not to put down plumbers at all.

Agreed. Plumbers are smart businesspeople. They’re highly skilled and paid for their expertise.

 

[Lecithin5]

Agreed. Plumbers are smart businesspeople. They’re highly skilled and paid for their expertise.

Correct. Of course my post didn’t mean to demean etc. plumbers- they’re skilled, and so are we

 

[Iso4ane]

And the modifiers schools also scale. Ease of positioning for a BMI of 35 is different than it is for 45 which is also different than it is for 55, etc.

 

[GassYous]

Agreed. Plumbers are smart businesspeople. They’re highly skilled and paid for their expertise.

But the toilets don't even have diabetes