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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

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Billing and Charges for CRRT

Andree V. Gardner

Pediatric Nephrology, Dialysis and Transplantation

DeVos Children’s Hospital

Grand Rapids, MI

PCRRT ~ June 26, 2004


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Types of Charges

  • Physician (Current Procedural Terminology)

    • Intensivist

    • Nephrologist

  • Facility (Charge Description Master)

    • Nursing Time

    • Support Staff Time

    • Supplies

      Capturing both is the key!


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Physician ~ Intensivist CPT’s

  • More than 25 to choose from

  • Common CPT’s are:

    • 99221-99223, 99231-99233, 99238-99239, 99251-99255, 99356-99357, 99261-99263, 99291-99297

      *A detailed list will be available at www.pcrrt.com


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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.


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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***


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Facility Billing Factors

  • Nursing Time

  • Support Staff Time

  • Supplies Needed

  • Equipment Maintenance & Depreciation


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Nursing

  • Average time for machine set-up and initiation of therapy

  • Straight time or overtime

  • Daily Bed Fees

  • Shift differentials

  • Additional bonuses


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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


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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 $$$$$$$$$$$$$

Supplies


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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


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Line Item Billing Example

12345 CRRT Set-Up

56789 CRRT Filter

09876 CRRT Lines

Bundled Billing Example

49546 Initiation of CRRT

Facility Billing


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Facility Billing

  • Either method works as long as you are diligent in determining your costs on an annual basis

    And what ever you do……………….


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DO NOT Throw away YOUR revenue!