Managing charge capture in a multi-hospital system that spans a variety of service lines and charges can prove to be a daunting task both in terms of ensuring claims are accurate and ensuring team members are well versed in each service line and charge type. While some health systems may train...Read More »
Q: Are outpatient departments considered part of the therapy cap for hospital-owned facilities? If so, do we need to bill with modifier –KX (Type of Bill 012X)? I want to ensure I’m billing correctly.Read More »
To close an open encounter, the following ingredients are required: one completed progress note, one chief complaint, a diagnosis, and a physician level of service. Combine all four in EPIC and you're ready to post charges.Read More »
Q: Can a hospital bill for orthotic or prosthetic supplies (e.g., leg brace for a patient in the ED or clinic) on the hospital claim? What are the requirements for billing these supplies? Is revenue code 0274 the correct revenue code? Are HCPCS codes needed?Read More »
For one chargemaster analyst, a typical workday revolves around maintaining compliance for two different systems: the hospital chargemaster and the Medicare Physician Fee Schedule (MPFS). The chargemaster is built upon an automated system which utilizes work queues.
At Grady Health System in Atlanta, monitoring key performance indicators (KPI) always comes back to the foundation KPI: hospital late charges. The timing of posting charges has a ripple effect. The longer you wait to post a charge, the more likely it is you will miss something. Read More »
Q: Are we able to report the IV infusions performed in the emergency department under revenue code 0450? Or do we have to report it under revenue code 0260? Would the IV codes be reported with revenue code 260 for departments other than emergency?Read More »
Q: When an acute rehabilitation hospital transfers a patient at 11:45 p.m. to an acute hospital emergency department, which sends the patient back to acute rehab the next morning, who is responsible for the bill? Read More »