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Billing and Charges for CRRT


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Billing and Charges for CRRT

  1. 1. Billing and Charges for CRRT Andree V. Gardner Pediatric Nephrology, Dialysis and Transplantation DeVos Children’s Hospital Grand Rapids, MI PCRRT ~ June 26, 2004
  2. 2. Types of Charges <ul><li>Physician (Current Procedural Terminology) </li></ul><ul><ul><li>Intensivist </li></ul></ul><ul><ul><li>Nephrologist </li></ul></ul><ul><li>Facility (Charge Description Master) </li></ul><ul><ul><li>Nursing Time </li></ul></ul><ul><ul><li>Support Staff Time </li></ul></ul><ul><ul><li>Supplies </li></ul></ul><ul><li>Capturing both is the key! </li></ul>
  3. 3. Physician ~ Intensivist CPT’s <ul><li>More than 25 to choose from </li></ul><ul><li>Common CPT’s are: </li></ul><ul><ul><li>99221-99223, 99231-99233, 99238-99239, 99251-99255, 99356-99357, 99261-99263, 99291-99297 </li></ul></ul><ul><ul><li>*A detailed list will be available at </li></ul></ul>
  4. 4. Physician ~ Nephrologist CPT’s <ul><li>90945 Single Evaluation of hemofiltration or other continuous renal replacement therapies </li></ul><ul><li>90947 Multiple Evaluation of hemofiltration or other continuous renal replacement therapies. </li></ul>
  5. 5. Physician Billing Tool <ul><li>Billing Cards </li></ul><ul><ul><li>Able to customize for each division </li></ul></ul><ul><ul><li>Size of a shirt or coat pocket </li></ul></ul><ul><ul><li>With the CPT Codes and abbreviated description </li></ul></ul><ul><ul><li>Patient Name, Date of Visit and Diagnosis Boxes </li></ul></ul><ul><ul><ul><li>Example will be at </li></ul></ul></ul><ul><ul><ul><li>***DOCUMENTATION*** </li></ul></ul></ul>
  6. 6. Facility Billing Factors <ul><li>Nursing Time </li></ul><ul><li>Support Staff Time </li></ul><ul><li>Supplies Needed </li></ul><ul><li>Equipment Maintenance & Depreciation </li></ul>
  7. 7. Nursing <ul><li>Average time for machine set-up and initiation of therapy </li></ul><ul><li>Straight time or overtime </li></ul><ul><li>Daily Bed Fees </li></ul><ul><li>Shift differentials </li></ul><ul><li>Additional bonuses </li></ul>
  8. 8. Support Staff Time <ul><li>Clerical & Stock-keeper </li></ul><ul><ul><li>What do these people contribute to the facility charge? Small tasks that add up to dollars that drive the cost per treatment! </li></ul></ul><ul><ul><ul><li>Input charges </li></ul></ul></ul><ul><ul><ul><li>Process physician and pharmacy orders </li></ul></ul></ul><ul><ul><ul><li>Order & Maintain stock </li></ul></ul></ul>
  9. 9. Supplies <ul><li>Filters </li></ul><ul><li>Lines </li></ul><ul><ul><li>Or sets with both items </li></ul></ul><ul><li>Gloves </li></ul><ul><li>Masks </li></ul><ul><li>Needles </li></ul><ul><li>Syringes </li></ul><ul><li>Saline </li></ul><ul><li>Heparin </li></ul><ul><li>Gauze </li></ul><ul><ul><li>What else do you use? </li></ul></ul><ul><ul><ul><li>Office Supplies </li></ul></ul></ul><ul><ul><ul><li>Forms </li></ul></ul></ul><ul><ul><ul><li>Account for all the items that cost you $$$$$$$$$$$$$ </li></ul></ul></ul>
  10. 10. Facility Billing ( C harge D escription M aster) <ul><li>Create CDM’s to reflect your facilities' billing protocols </li></ul><ul><li>In those CDM’s capture what you are really using in your treatments </li></ul><ul><li>Be sure the billing office is using the proper revenue codes </li></ul>
  11. 11. Facility Billing <ul><li>Line Item Billing Example </li></ul><ul><ul><ul><li>12345 CRRT Set-Up </li></ul></ul></ul><ul><ul><ul><li>56789 CRRT Filter </li></ul></ul></ul><ul><ul><ul><li>09876 CRRT Lines </li></ul></ul></ul><ul><li>Bundled Billing Example </li></ul><ul><ul><ul><li>49546 Initiation of CRRT </li></ul></ul></ul>
  12. 12. Facility Billing <ul><li>Either method works as long as you are diligent in determining your costs on an annual basis </li></ul><ul><li>And what ever you do………………. </li></ul>
  13. 13. DO NOT Throw away YOUR revenue!
  14. 14. Thank you!