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 • 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
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
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
Line Item Billing Example 12345 CRRT Set-Up 56789 CRRT Filter 09876 CRRT Lines Bundled Billing Example 49546 Initiation of CRRT Facility Billing
Facility Billing • Either method works as long as you are diligent in determining your costs on an annual basis And what ever you do……………….