Post on 16-Dec-2015
Billing and Charges for CRRT
Andree V. GardnerPediatric Nephrology, Dialysis and Transplantation
DeVos Children’s HospitalGrand 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, 99238-99239, 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
• 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
• Line Item Billing Example
• 12345 CRRT Set-Up
• 56789 CRRT Filter
• 09876 CRRT Lines
• Bundled Billing Example
• 49546 Initiation of CRRT
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!