Disclosures: Clifford R. Kissling, MD: No financial relationships or conflicts of interest

Objective: The ability to accurately assess work relative value unit (wRVU) production is important to both medicolegal issues and physician reimbursement. Resident physicians receive little formal education on coding. Converting medical documentation to a common procedural terminology (CPT) code and its associated wRVU is often absent from training. This training deficit places graduating residents at a disadvantage when negotiating employment terms, as productivity is often quantified in wRVUs for employment contracts.

Design: Prospective cohort studySetting : Inpatient rehabilitation hospitalParticipants : Four resident physicians in their first year of physical medicine and rehabilitation training

Interventions: Participants each tallied patient encounters to estimate wRVUs generated over four days (180 total encounters). Education was then provided on CPT code generation and subsequent conversion to wRVU, including an interactive session with a medical coder. Participants repeated estimation of wRVUs on documentation (105 total encounters) completed after education. Estimated totals were compared to the CPT code determined by a medical coding specialist for each encounter.

Main Outcome Measures: Primary outcome measure was the accuracy of predicted wRVUs following educational session.

Results: Prior to coding education, estimated wRVU totals differed on average by 76 (range: 174.2) when compared to actual (standard deviation: 82.34). After education, the difference between estimated and actual wRVUs was only 9.6 (range: 5.88, standard deviation: 2.59), one eighth of the previous difference. The average wRVU generated for initial hospital visits increased from 3 to 3.86.Conclusions: This initial educational intervention improved participant accuracy in predicting their wRVU production by a factor of eight. The reduced standard deviation and range also suggests improvement after education. Increased knowledge of wRVUs empowers residents entering the workforce to analyze contracts, accurately capture their actual work, and avoid fraudulent billing. Further quality improvement projects will be aimed at residents in outpatient clinics, interventional procedures, and inpatient consult services.

Level of Evidence: Level III

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/enhancing-comprehension-of-relative-value-units-among-resident-physicians/