In the next few weeks we will be contacting a random selection of members to participate in an important AMA/Specialty Society Relative Value Scale Update Committee (RUC) survey of physician work for codes 64633-64636 which describe destruction of facet joints. The Medicare payment schedule is based on physician work, practice expense and professional liability insurance. Our specialty needs your help to assure relative values will be accurately and fairly presented to the Centers for Medicare and Medicaid.
AAPM is conducting this survey for the RUC in partnership with several other medical specialties including the American Academy of Physical Medicine and Rehabilitation, American Society of Anesthesiologists, and the Spine Intervention Society. If you are a member of one or more of these additional societies, you may see a survey request from them (rather than from AAPM). In such instance, we ask that you treat their request as similarly vital. We will compile all relevant survey data from the partnering societies for our presentation to the AMA RUC.
The survey is being conducted at the request of the RUC and stems from issues related to budget neutrality. As part of the RUC process, specialty societies must provide an estimated utilization for any new or revised family of codes. CMS productivity data dating back to 2014 identified concerns related to the use of the add-on codes that identify each additional joint treated. The possibility of incorrect coding of per nerve instead of per joint was discussed and a CPT Assistant article was published in February 2015. Changes were made to the 2016 CPT guidelines for this group of codes clarifying the correct reporting of the add-on codes. The RUC allowed time for these efforts to take effect and reviewed the utilization data again in October 2019. The Relativity Assessment Workgroup (RAW) of the RUC noted that the growth in these services is appropriate as patient population requiring these services has grown. However, due to the extensive growth and original incorrect assumptions about distribution of reporting, the Workgroup determined that a new survey is required.
If you receive a request to survey these codes, please remember your input in this survey is vital. The specialty societies ability to impact the work recommendations is dependent on robust and meaningful data. If you have any questions, please contact Emily Hill, AAPM Coding and Reimbursement Liaison, at: [email protected].