question about RVUs

[jamochacreampie]

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How many RVUs do typical gen derms produce on average?

The reason I ask is because a contract I am looking at has a base salary + bonus if conversion factor x RVU is greater than the salary, and I would like to figure out approximately how many patients I would need to see in order to have the possibility of bonus. I feel like most visits will be 99212 or 99213 - which is 0.48 and 0.97 RVU based on what I found online, but i am interested how this translates in the real world. Thanks!!

 

[FIREitUP]

I think you need to first ask yourself why you are billing so many 99212's

 

[MOHS_01]

I think you need to first ask yourself why you are billing so many 99212's

With medical necessity audits and time expectations per each E&M CPT, my bet is the coding error is toward upcoding, particularly when relying upon the exam portion to support the higher codes. Many general derm follow ups would be 99212 if held to the scrutiny of an audit, particularly with recent “interpretations” by “coding experts”. It’s a more hostile world out there than most realize, I’m afraid.

 

[jamochacreampie]

With medical necessity audits and time expectations per each E&M CPT, my bet is the coding error is toward upcoding, particularly when relying upon the exam portion to support the higher codes. Many general derm follow ups would be 99212 if held to the scrutiny of an audit, particularly with recent “interpretations” by “coding experts”. It’s a more hostile world out there than most realize, I’m afraid.

Yes, this is how I've been taught...that routine follow ups for one problem is 99212. Fbse could be 99214 but I've heard some people say that even this is shady despite having an extensive exam.

 

[FIREitUP]

Yes, this is how I've been taught...that routine follow ups for one problem is 99212. Fbse could be 99214 but I've heard some people say that even this is shady despite having an extensive exam.

I guess we were taught a bit differently. If you do an FBSE and have the HPI points there's no reason you should ever put a 99213. For a follow up, unless it is 2 seconds, you can still get sufficient HPI points and often it isn't difficult to justify a 99213 based on medical complexity or exam (I think you only need 8 exam points for a 99213 which isn't difficult to accomplish).

Other instances where I routinely utilize 99212 CPT is when I have done either ILK, benign or malignant destruction which generally consumes HPI points.