88305 RVU RUC (April 2010)

 Work RVU (MD) stable.

VIGNETTE

Excision of a 1-cm pigmented skin lesion with irregular borders from the back of a 35-year-old female.

Obtain and review clinical history and diagnostic studies, including examination of previous study reports and communications with other professionals. Perform examination of specimen and interpret test results. Compare to previous study reports. Consider relevant statistical variations. Identify clinically meaningful findings. Review literature or research during examination of test result. Dictate and prepare pathology report. Report sign-out with any concurrent telephone communication with other professionals.

RUC APRIL 2010

https://www.ama-assn.org/about/rvs-update-committee-ruc/ruc-recommendations-minutes-voting?check_logged_in=1

 

https://www.ama-assn.org/system/files/april-2010-ruc-meeting-minutes.pdf

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Specialty Recommendation RVW:

RUC Recommendation RVW:

The pathology consultation services were identified by the RUC's Five-Year Review Identification Workgroup through its CMS screen for Harvard-valued codes with utilization greater than 1 million. At the October 2009 RUC Meeting, the RUC recommended that all of the identified codes in this family be surveyed using the standard RUC survey instrument or present an alternative methodology to the Research Subcommittee for review, or present a code change proposal to the CPT Editorial Panel for their review. The College of American Pathologists conducted a standard RUC Survey for each of the pathology consultation codes and had between 84 and 165 survey respondents for each survey. The survey data from this robust survey demonstrates that the current work associated with these services is accurate and furthermore supports the specialty society's recommendation that there is no compelling evidence to change the current work of these services. 88300 Level I - Surgical pathology, gross examination only The RUC reviewed the survey data for 88300. The specialty society recommended and the RUC agreed that the surveyed time accurately reflects the service being performed. The RUC reviewed the surveyed code in comparison to 88311 Decalcification procedure (Work RVU=0.24). The RUC noted that the surveyed code has slightly more intra-service time as compared to the reference code, 10 minutes and 7 minutes, respectively. Although the survey median for this service was 0.27 Work RVUs, the specialty society recommended and the RUC agreed that there was no compelling evidence to change the current value for this service, 0.08 work RVUs. Therefore, the RUC recommends 0.08 Work RVUs for 88300. 88302 Level II - Surgical pathology, gross and microscopic examination The RUC reviewed the survey data for 88302. The specialty society recommended and the RUC agreed that the surveyed time accurately reflects the service being performed. The RUC reviewed the surveyed code in comparison to 88334 Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (Work RVU=0.73). The RUC noted that the surveyed code had significantly less intra-service time as compared to the reference code, 11 minutes and 20 minutes, respectively. In addition, the RUC agreed that the reference code required more technical skill and physical effort and cased more psychological stress to perform in comparison to the surveyed code. Although the survey 25th percentile for this service was 0.30 Work RVUs, the specialty society recommended and the RUC agreed that there was no compelling evidence to change the current value for this service, 0.13 work RVUs. Therefore, the RUC recommends 0.13 Work RVUs for 88302. 88304 Level III - Surgical pathology, gross and microscopic examination The RUC reviewed the survey data for 88304. The specialty society recommended and the RUC agreed that the surveyed time accurately reflects the service being performed. The RUC reviewed the surveyed code in comparison to 88334 Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (Work RVU=0.73). The RUC noted that the surveyed code had slightly less intra-service time as compared to the reference code, 15 minutes and 20 minutes, respectively. In addition, the RUC agreed that the reference code required more technical skill, mental effort and judgment and cased more psychological stress to perform in comparison to the surveyed code. Although the survey 25th percentile for this service was 0.45 Work RVUs, the specialty society recommended and the RUC agreed that there was no compelling evidence to change the current value for this service, 0.22 work RVUs. Therefore, the RUC recommends 0.22 Work RVUs for 88304. 88305 Level IV - Surgical pathology, gross and microscopic examination The RUC reviewed the survey data for 88305. The specialty society recommended and the RUC agreed that the surveyed time accurately reflects the service being performed. The RUC reviewed the surveyed code in comparison to 88323 Consultation and report on referred material requiring preparation of slides (Work RVU=1.83). The RUC noted that the surveyed code had less intra-service time as compared to the reference code, 25 minutes and 56 minutes, respectively. In addition, the RUC agreed that the reference code was overall a more intense procedure to perform as compared to the surveyed code. Although the survey 25th percentile for this service was 1.50 Work RVUs, the specialty society recommended and the RUC agreed that there was no compelling evidence to change the current value for this service, 0.75 work RVUs. Therefore, the RUC recommends 0.75 Work RVUs for 88305. 88307 Level V - Surgical pathology, gross and microscopic examination The RUC reviewed the survey data for 88307. The specialty society recommended and the RUC agreed that the surveyed time accurately reflects the service being performed. The RUC reviewed the surveyed code in comparison to 88325 Consultation, comprehensive, with review of records and specimens, with report on referred material (Work RVU=2.50). The RUC noted that the surveyed code had less intra-service time as compared to the reference code, 47 minutes and 80 minutes, respectively. In addition, the RUC agreed that the reference code was overall a more intense service to perform as compared to the surveyed code. Although the survey 25th percentile for this service was 2.00 Work RVUs, the specialty society recommended and the RUC agreed that there was no compelling evidence to change the current value for this service, 1.59 work RVUs. Therefore, the RUC recommends 1.59 Work RVUs for 88307. 88309 Level VI - Surgical pathology, gross and microscopic examination The RUC acknowledged that 88309 was reviewed during the 2005 Five-Year Review. Based on the review of the other surgical pathology services, the RUC agrees that it would be appropriate that the recommendations from that review be reaffirmed. The RUC recommends that the current value of 2.80 for 88309 be maintained and that the recommendations from the 2005 Five Year Review be reaffirmed. PLI Crosswalks: The RUC recommends that the PLI RVUs be maintained and that the PLI crosswalk for each of these codes be the existing code.