Applying for CPT Codes and Obtaining RVUs for CPT Codes

The Academy Needs You! Fill Out a RUC Survey
We need experts to fill out RUC surveys for the AMA Speciality Society/ Relative Value Update Committee! The RUC is a joint effort of the American Medical Association and medical specialty societies that makes recommendations on revising and updating the resource-based relative valye scale (RBRVS), which is utilized by Medicare and many private payers. Information, such as the time it takes for you to perform certain services for patients are derived by surveying physicians such as you who have expertise in peforming those services. This information is critical to ensure appropriate valuation.

Last summer, the Academy performed a RUC survey for CPT code 31231, diagnostic nasal endoscopy. We received only the minimal number of member responses, and the results were difficult to interpret. At the September 2011 RUC meeting, Dr. Wayne Koch, RUC Advisor for the Academy, and Dr. John Lanza, RUC Alternative Advisor, met with RUC Panel members in a pre-facilitation to discuss potential problems with the recent survey data. That panel recommended that the Academy resurvey its members in an effort to clarify the inconsistencies.

The Academy strongly encourages members who are familiar with a procedure to take the time to complete surveys. Filling out a survey takes about 20 minutes. Before completing this survey, please review important information by viewing a webinar. Visit www.entnet.org/academyu to access your AcademyU account, then click under Business of Medicine, Practice Management, session titled, "Understanding the RUC Survey Instrument- 31231." Additional background on the RUC survey process and survey instrument are included in the August Bulletin article (login required). Surverys are due Tuesday, December 13, 2011. 

How to Apply for a CPT Code - New Technology Pathway

There are specific procedures in place both at the Academy and within the AMA to evaluate recommendations to changes in the Current Procedural Terminology (CPT) code set. The Academy has a dedicated CPT & Relative Value Committee to address these issues, experienced physician representation to the CPT Editorial Panel and the RVS Updating Committee (RUC) through the Physician Payment Policy Workgroup (aka “3P”), and a dedicated staff member to interact with the stakeholders in the CPT development process.  

How to Obtain Relative Value Units for CPT codes

Immediately following the Editorial Panel’s acceptance of the new code proposal, the RUC process begins.  All RUC Advisors have an opportunity to indicate a “level of interest” in developing relative value recommendations for the new code. All societies have 3 options:

1. Survey their members to obtain data on the amount of work involved in the services and develop recommendations
2. Comment in writing on recommendations developed by other societies
3. In the case of editorially changed/ revised codes, they could decide that the coding change does not require action because it does not significantly alter the nature of the service or the previously assigned relative value, or; take no action because the codes are not used by physicians in their specialty.

Updated on November 30, 2010