Billing for Ancillary Bedside Procedures Training Handbook
Pack includes 5 handbooks
Denise Williams, RN, COC
Hospitals are often concerned that charging separately for bedside procedures will be considered “double dipping”—perhaps rightfully so, because the rules can be complex. As a result, hospitals frequently miss payment for services that can be billed and reported separately by rolling them into charges for room-related or observation services. However, CMS allows facilities to line-report many items that are often thought of as outpatient nursing services (e.g., injections, transfusions, and certain supplies) for both inpatients and outpatients.
The Billing for Ancillary Bedside Procedures training handbook will help staff understand CMS’ guidelines and regulations and provide guidance for development of policies and procedures to ensure that bedside procedures are billed appropriately. The handbook includes a sample policy with explanations and step-by-step instructions, as well as a clear explanation of Medicare's complex rules governing separate charges for bedside procedures.
This handbook educates its readers on when and how to bill separately for bedside procedures and is delivered in an easy-to-reference and distributable format.
Table of Contents
- What Is a Bedside Procedure?
- Documentation basics
- Types and methods of documentation
- Specific documentation considerations for inpatient procedures
- The Importance of Charging and Reporting Bedside Procedures
- Separate Reporting Versus Inclusion in the Room Rate
- Considerations for classification
- Routine services
- Regular room, dietary, and nursing services
- Minor medical and surgical supplies
- Medical social services and psychiatric social services
- Bedside procedures
- Making the decision
- Charge capture process
- Policy documentation
- Reporting Services on Claims
- Chargemaster considerations
- Payers Weigh In
- Other third-party payers
- Sample Policy and Procedure
- Sample policy: Inpatient room rate
Staff members that would benefit from this resource include:
Outpatient billing managers and staff, compliance managers and staff, chargemaster coordinators, inpatient billing managers and staff, charge nurses, nurse auditors, decision support, revenue integrity, finance, clinical staff, nursing staff, physician advisors, CFO, patient financial services, UR/UM professionals, medical executive committee, administration, HIM managers and directors.
About the Author
Denise Williams, RN, COC, AHIMA ICD-10 ambassador, is senior vice president of the revenue integrity division and compliance auditor at Revant Solutions in Ft. Lauderdale, Florida. She has more than 30 years of healthcare experience, including a background in multiple areas of nursing. For the past 20 years, Williams has been in the field of coding and reimbursement and has performed numerous E&M, OP surgical, ED, and observation coding chart reviews from the documentation, compliance, and reimbursement perspectives. She serves as a contributing author to articles published in HCPro’s APC Insider and Briefings on APCs and is a nationally recognized speaker on various coding and reimbursement topics.
Published: April 2016
Page count: 206