CODING & DOCUMENTATION

 

Fam Pract Manag. 2019 Nov-Dec;26(6):30.

Author disclosure: no relevant financial affiliations disclosed.

WORK RELATIVE VALUE UNITS

Q

Where can I find a list of current work relative value units (RVUs) for each CPT code?

A

You can download Excel files from the Centers for Medicare and Medicaid Services (CMS) at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/PFS-Relative-Value-Files.html. If you are seeking this information in relation to a service provided on a particular date, be sure to select the pertinent file. For example, the first file published in 2019 is listed as RVU19A, and the last file, updated in October, is labeled RVU19D. The CMS files relate to payment under the Medicare Physician Fee Schedule, but many private payers use these files to value their services as well.

VACCINATION REFUSAL

Q

What should I report when I provide a preventive medicine service with immunization counseling to a child but the parents refuse the immunization?

A

Report the age-appropriate preventive E/M service code (99391-99394) with the appropriate ICD-10 routine child health examination code (Z00.121 or Z00.129) as well as Z28.82, “Immunization not carried out because of caregiver refusal.” If the child is beyond the recommended age range for an immunization, you should also code Z28.3, “Underimmunization status.” When caring for an ill child who is underimmunized, assigning a diagnosis of underimmunization helps to show that a higher level of medical decision making was required.

MARIJUANA USE

Q

We are seeing more patients who report marijuana use as part of their social history but who have no related complaints. Should a code be assigned for this?

A

No. The ICD-10 guidelines state that codes for psychoactive substance use disorders (e.g., F12.90, “Cannabis use, unspecified, uncomplicated”) should be reported only when the psychoactive substance use is associated with a physical, mental, or behavioral disorder and the re

ABOUT THE AUTHOR

Cindy Hughes is an independent consulting editor based in El Dorado, Kan., and a contributing editor to FPM.

Author disclosure: no relevant financial affiliations disclosed.

WE WANT TO HEAR FROM YOU

Send questions and comments to fpmedit@aafp.org, or add your comments below. While this department attempts to provide accurate information, some payers may not accept the advice given. Refer to the current CPT and ICD-10 coding manuals and payer policies.

 
 

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