Transcript Billing and Charges for CRRT - Pediatric Continuous Renal

Billing and Charges for CRRT
Andree V. Gardner
Pediatric Nephrology, Dialysis and Transplantation
DeVos Children’s Hospital
Grand Rapids, MI
PCRRT ~ June 26, 2004
Types of Charges
• Physician
(Current Procedural Terminology)
– Intensivist
– Nephrologist
• Facility
(Charge Description Master)
– Nursing Time
– Support Staff Time
– Supplies
Capturing both is the key!
Physician ~ Intensivist CPT’s
• More than 25 to choose from
• Common CPT’s are:
– 99221-99223, 99231-99233, 9923899239, 99251-99255, 99356-99357,
99261-99263, 99291-99297
*A detailed list will be available at www.pcrrt.com
Physician ~ Nephrologist CPT’s
• 90945 Single Evaluation of
hemofiltration or other continuous
renal replacement therapies
• 90947 Multiple Evaluation of
hemofiltration or other continuous
renal replacement therapies.
Physician Billing Tool
• Billing Cards
– Able to customize for each division
– Size of a shirt or coat pocket
– With the CPT Codes and abbreviated
description
– Patient Name, Date of Visit and
Diagnosis Boxes
• Example will be at www.pcrrt.com
***DOCUMENTATION***
Facility Billing Factors
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•
•
•
Nursing Time
Support Staff Time
Supplies Needed
Equipment Maintenance &
Depreciation
Nursing
• Average time for machine set-up and
initiation of therapy
• Straight time or overtime
• Daily Bed Fees
• Shift differentials
• Additional bonuses
Support Staff Time
• Clerical & Stock-keeper
– What do these people contribute to the
facility charge? Small tasks that add up
to dollars that drive the cost per
treatment!
• Input charges
• Process physician and pharmacy orders
• Order & Maintain stock
Supplies
• Filters
• Lines
– Or sets with both
items
•
•
•
•
Gloves
Masks
Needles
Syringes
• Saline
• Heparin
• Gauze
– What else do you
use?
• Office Supplies
• Forms
• Account for all the
items that cost you
$$$$$$$$$$$$$
Facility Billing
(Charge Description Master)
• Create CDM’s to reflect your
facilities' billing protocols
• In those CDM’s capture what you are
really using in your treatments
• Be sure the billing office is using the
proper revenue codes
Facility Billing
• Bundled Billing
Example
• 49546 Initiation of
CRRT
• Line Item Billing
Example
• 12345 CRRT Set-Up
• 56789 CRRT Filter
• 09876 CRRT Lines
Facility Billing
• Either method works as long as you
are diligent in determining your costs
on an annual basis
And what ever you do……………….
DO NOT Throw away YOUR
revenue!
Thank you!