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!