Unit6Assignment2 (2) (1)

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Purdue Global University *

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Jan 9, 2024

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Unit 6 Expected Payment Worksheet (Use this document as your worksheet.) For this assignment, refer to the readings from Health Information Management: Concepts, Principles, and Practice in the PG Library and the sample calculation below to answer the questions that follow. Table W14.2: Sample 2014 RVUs for selected HCPCS Codes HCPCS Code Description Work RVU Practice Expense RVU Malpractice Expense RVU 99203 Office Visit 1.23 0.48 0.09 99204 Office Visit 2.00 0.71 0.12 10080 I&D of pilonidal cyst, simple 1.17 1.11 0.11 45380 Colonoscopy with biopsy 4.43 1.73 0.35 52601 TURP, complete 12.35 5.1 0.87   Table W14.3: Sample GPCIs for selected U.S. Cities City Work GPCI Practice Expense GPCI Malpractice Expense GPCI St. Louis 1.000 0.946 0.941 Dallas 1.010 1.063 1.061 Seattle 1.010 1.115 0.819
Philadelphia 1.020 1.098 1.386   Example Calculation How much can a physician in St. Louis bill Medicare for an office visit for a new patient with a detailed history and physical and low-complexity medical decision making (assuming the patient has met any deductible for the year)? Calculation: [RVUw x GPCIw) + (RVUpe x GPCIpe) + (RVUm x GPCIm)] x CF = Payment    Example: Calculation: Billing 99203 in St. Louis 1.23 x 1.000 = 1.23 0.48 × 0.946 = 0.45 0.09 × 0.941 = 0.08 Total = 1.76 × 34.0682 = $59.96 Answer: $59.96   Using the formula above, the tables, and the conversion factor from your textbook, answer the following questions. Make sure to show all of your calculations .   Calculate the expected payment for a TURP in Dallas. 12.35x1.010= 12.47 5.1x1.063=5.42 0.08x1.061= 0.08 17.97x34.0230=611.39 Answer: $611.39 Calculate the expected payment for a colonoscopy with biopsy in St. Louis. 
4.43x1.000=4.43 1.72x0.946=1.63 0.35x0.941=0.33 6.39x34.0230=217.41 Answer: $217.41 Calculate the expected payment for an incision and drainage of a pilonidal cyst in Seattle. 1.17x1.010=1.18 1.11x1.115=1.24 0.11x0.819=0.09 2.51x34.0230=85.40 Answer:$85.40
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