Lucky Number 3! Don’t Miss This $33 Increase for Intubation Code 31500

31500 emergency intubation

The 2017 Medicare Physician Fee Schedule (MPFS) final rule estimated a 0 percent impact on total allowed charges for emergency medicine this year. But did you catch the nice boost for 31500 (Intubation, endotracheal, emergency procedure)? Here are the details on that change for those of you who enjoy a nice fee schedule adventure.

Catching 31500 Coding Opportunities Pays Off This Year

In 2016, Medicare identified emergency intubation code 31500 as potentially misvalued. After surveying specialty societies, the RUC recommended 3.00 work RVUs for 31500. In 2016, the code had 2.33 work RVUs, so 3.00 would be an increase worth noting.

Definition time: In case you need some help deciphering that last paragraph, RUC refers to the American Medical Association/Specialty Society Relative (Value) Update Committee. And work RVUs are the relative value units (RVUs) assigned to the physician work (time and intensity) involved in completing the service described by the code. When you add together the work RVUs, practice expense RVUs, and malpractice RVUs assigned to a code, and then multiply that sum by the conversion factor (35.8887 in 2017), you get the national rate Medicare pays for a code. The final amount you actually receive will be adjusted further based on elements like geography and possibly the modifiers and other codes you assign.

Back to 31500: In response to the RUC suggestion of 3.00, Medicare said 2.66 work RVUs seemed more accurate, suggesting the time and intensity were similar to 65855 (Trabeculoplasty by laser surgery). That little tidbit is on page 80285 of the 2017 MPFS final rule.

Commenters told Medicare that the emergent nature of 31500 meant glaucoma treatment code 65855 wasn’t a fair comparison. After considering that comment and the fact that the recent surveys showed an intraservice time of 10 minutes for 31500 (instead of the 5 minutes used for previous 31500 pricing), Medicare decided in the final rule to go with 3.00 work RVUs for 31500.

That increase along with some smaller increases to the practice expense RVUs and malpractice RVUs means that the 2016 national rate of $113.14 got lifted to $146.07 in 2017. That’s about $33 more! All you need to do to collect that extra reimbursement is to continue to code emergency endotracheal intubation correctly based on the documentation from the provider.

How About You?

Do you code for emergency medicine? Are there any other codes you feel are misvalued?


Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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