xxbowiexx Posted November 7, 2011 Share Posted November 7, 2011 Accurate documentations not only help reflect the amount of work we put into our patients, it can help improve RVUs. Since i'm a new PA, i always questioned how to accurately documenting my work in a precise manner. This is where i hope my fellow PAs will share your "macros" or documentation tips via this thread. For instance: a patient suffered a rib fracture, you document "Definitive Fracture Care" in your note and providing care including pain control, incentive spirometer and instruction for patient to return for signs of pneumonia. By writing the phrase "Definitive Fracture Care" in your note will reflect higher RVUs. Lets hear it. Link to comment Share on other sites More sharing options...
Moderator ventana Posted November 7, 2011 Moderator Share Posted November 7, 2011 document chronic stable problems i.e. blood pressure stable at 120/80 on hydrochlorothiazide prior to manage this typically difficulty doing next higher billing code. Link to comment Share on other sites More sharing options...
xxbowiexx Posted November 7, 2011 Author Share Posted November 7, 2011 Finger splinting for a simple finger fracture/dislocation can help improve outcome and add RVUs. The splint can easily be done by the provider. CPT code is 29130 and yield 0.83 RVU. More info of top 20 ED Reimbursement Code can be found here: http://www.acep.org/Content.aspx?id=78699 Link to comment Share on other sites More sharing options...
Jason09 Posted November 8, 2011 Share Posted November 8, 2011 1) Yeah splinting adds RVUs but correct me if I'm wrong you have to document after splint placed alignment good and neurovascularly intact to get all the RVUs. 2) Also for toothaches which are normally low RVUs I do a supraperiosteal block and document on this. Pt's love and boost RVUs. 3) I make sure to properly document all lacs as one of the most common procedures i.e wounds greater then 3.1 cm, 5.1, and 7.1 are different billing rates and complexity (believe these are the right lengths). 4) Apparently documenting pulse ox gives 1 RVU for a patient, just started doing this. 5) If I give IV fluids I state volume depletion/dehydration or something along those lines to boost diagnosis made Link to comment Share on other sites More sharing options...
xxbowiexx Posted November 8, 2011 Author Share Posted November 8, 2011 Jason: all are great points. Thanks for reminding about the post splint documentation. I do document neurovascular function post-splint but have not document alignment, so i will start doing so. As far as toothache, true "pain" patient loves blocks but most of the other toothache patients....well, they are not that in tune to getting immediate relief if you know what i mean. If i have repeat toothache patient, i tend to prescribe Lortab Elixir instead of tabs. As far as lac, i thought significant length difference is either < or > than 2.5 cm, but you are probably right. Link to comment Share on other sites More sharing options...
ksticka Posted May 15, 2012 Share Posted May 15, 2012 Our company is pushing "strive for five", in the diagnosis section we need to list at least 5 diagnoses and/or backslashrule outs. They think this will help. I've also heard that a diagnosis of cough and fever pays hgher than URI. Link to comment Share on other sites More sharing options...
xxbowiexx Posted May 16, 2012 Author Share Posted May 16, 2012 do you mean differential diagnosis? Good point on "cough" and "fever" vs URI. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted May 16, 2012 Moderator Share Posted May 16, 2012 I believe the lac sizes are less than 2.5 cm, 2.6-5.0 cm, 5.1-7.5 cm, etc always list at least 1 FH and SH feature always write splint notes including rechecks always mention reviews of old charts or consults if done always document critical care time include a ddx in your note and a medical decision making section( unlikely to be PE given xyz, unlikely acs given nl enzymes and nl treadmill, etc) Link to comment Share on other sites More sharing options...
Moderator ventana Posted May 16, 2012 Moderator Share Posted May 16, 2012 If i have repeat toothache patient, i tend to prescribe Lortab Elixir instead of tabs. . OMG the candy man has arrived PLEASE stop giving out opiates to the simple tooth ache patient high dose nsaid and pen v-k NO opiates unless the bone is showing also, NO opiates or benzo's for the patient who ran out who says "I am going to withdrawl" but has stable VS.... you are just getting played for drugs! Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted May 17, 2012 Moderator Share Posted May 17, 2012 I believe the lac sizes are less than 2.5 cm, 2.6-5.0 cm, 5.1-7.5 cm, etcalways list at least 1 FH and SH feature always write splint notes including rechecks always mention reviews of old charts or consults if done always document critical care time include a ddx in your note and a medical decision making section( unlikely to be PE given xyz, unlikely acs given nl enzymes and nl treadmill, etc) What's funny is that I list all this anyway, but we get absolutely no RVU's as we are strict salary Link to comment Share on other sites More sharing options...
riccorman Posted February 5, 2017 Share Posted February 5, 2017 Hello. I am an employed primary care physician who was recently transitioned from a salaried position to a productivity-based employment contract. Prior to this, I never really paid much attention to my productivity, other than listening to administrators telling me to "see more patients." Once my compensation became tied to these numbers, however, I became intensely interested in how my productivity is determined. I developed an iOS app to allow me to calculate my work RVUs at the time of coding, while I'm seeing patients. Using the app in my practice has dramatically increased my productivity by making me aware of how the CPT codes I apply affect my reimbursement. As an added bonus, I can now keep track of my OWN productivity, and I don't have to rely blindly on a health care administrator to provide me that data. I have further developed this app, RVUcalc, for the use of other clinicians and made it available for download in the iTunes App Store for $3.99. If there is enough interest, I will also port the application to the Android platform. It is a very simple app, but it is lightning fast and very easy to use. I have found many different uses for it in my practice. But I think its biggest value lies in what it has taught me about the relative values of the CPT codes I use every day, and how I can optimize those codes for maximum compensation. I feel that it would be very beneficial to EVERY provider on a production-based compensation model, or any provider who wants to gain insight into their productivity numbers. It is available in the iTunes app store and more information, including a preview video, can be found at my website: http://rvucalc.com I sincerely hope that someone here finds this helpful. It has made a HUGE difference for me. Link to comment Share on other sites More sharing options...
ohiovolffemtp Posted February 8, 2017 Share Posted February 8, 2017 How much of the RVU do you get credit for if the tech places the splint and you just check it - documenting proper application & intact distal neurovascular status? Link to comment Share on other sites More sharing options...
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