CPT codes are issued when something is done on a patient to define a medical procedure performed by a healthcare professional in a facility, clinic, or hospital. RVU – The RVU shows how much time, expertise, training and effort a doctor must devote to perform a particular service. Therefore, RVU can be used to determine how much time and effort physicians devote to treating patients. It is also used to determine the amount of payment due to suppliers (Dunn et al., 2020). Insurance companies use RVUs to determine how much a provider should pay based on the work the provider has done, the cost of doing so, and their responsibilities. (ICD10): A code that identifies a wide variety of diseases, disorders, and conditions that a patient may have. Together with CPT, these codes define the invoice amount. DRG) – Medicare class created by CMS to group patients based on diagnosis. Patients are billed per diagnosis, so factors such as length of stay do not affect their price (Berger et al., 2021). This compels healthcare professionals to provide effective care. Groups of codes representing different processes, services and deliveries within HCPCS. In order to bill the insurance company correctly, these codes are used. continue…
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