CPT and RUC Activities for General Surgeons
The College's General Surgery Coding and Reimbursement Committee (GSCRC), formed in 1991, is responsible for the College's Current Procedural Terminology (CPT) and AMA/Specialty Society RVS Update Committee (RUC) activities. The Committee has two charges: to develop CPT coding proposals for general surgery to go the CPT Editorial Panel and, once adopted by the Editorial Panel, to recommend relative values for the codes performed by general surgeons.
In developing CPT proposals, the Committee is constantly reviewing the codes used by general surgeons to identify codes that need to be deleted or revised. They are also looking for new services that do not have a code. The resulting coding proposals are taken to the CPT Editorial Panel for adoption, adoption with change, or rejection. In addition to developing coding proposals, the GSCRC sponsors workshops on CPT and other educational efforts regarding code use.
Once adopted by the CPT Editorial Panel, the coding package goes to the RUC. The RUC makes recommendations for work and practice expense relative values to the Centers for Medicare & Medicaid Services (CMS). Their process is to ask the specialties that will be using a code to make recommendations to the RUC for values. The GSCRC is responsible for developing the recommendations, frequently by surveying general surgeons to see what values the code should have. The RUC reviews the recommendations from all the specialty societies and makes the final recommendations to CMS.
Every five years there is an opportunity to review values that are not correct because of a change in the practice of medicine or because an error was made in assigning the relative values. The GSCRC and the RUC participate in the five-year reviews of the Medicare fee schedule, which was mandated by the law that created the fee schedule.
A number of people on the GSCRC hold formal positions in the CPT and RUC processes. John Gage, MD, FACS, is the representative for general surgery on the RUC, Charles Mabry, MD, FACS, is the alternate RUC member, and Frank Opelka, MD, FACS, is a member of the Advisory Committee to the RUC. Karen Borman, MD, FACS, serves on the CPT Editorial Panel and Albert Bothe, Jr., MD, FACS, serves on the CPT Advisory Committee.
March 2000
Prepared by the Health Policy and Advocacy Department
Revised March 7, 2005