Billing and Charges for CRRT

1
Billing and Charges for CRRT

• Andree V. Gardner
• Pediatric Nephrology, Dialysis and
  Transplantation
• DeVos Childrens Hospital
• Grand Rapids, MI
• PCRRT June 26, 2004

2
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 CPTs

• More than 25 to choose from
• Common CPTs 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

4
Physician Nephrologist CPTs

• 90945 Single Evaluation of hemofiltration or
  other continuous renal replacement therapies
• 90947 Multiple Evaluation of hemofiltration or
  other continuous renal replacement therapies.

5
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

8
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

9
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
  

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Facility Billing (Charge Description Master)

• Create CDMs to reflect your facilities' billing
  protocols
• In those CDMs capture what you are really using
  in your treatments
• Be sure the billing office is using the proper
  revenue codes

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Facility Billing

• Line Item Billing Example
• 12345 CRRT Set-Up
• 56789 CRRT Filter
• 09876 CRRT Lines

• Bundled Billing Example
• 49546 Initiation of CRRT

12
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!
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Thank you!