Coding and Billing for Hospital Supplies (Audio Conference)

AUDIOCONFERENCE ON TAPE, CD OR AUDIO ARCHIVE

Sponsored by
Briefings on APCs

presented on May 2, 2007

Coding and billing for supplies is difficult. It's hard to find official guidance, and when you do, it's not always clear whether supplies are inherent to a procedure (and not separately billable), and which supplies you can bill separately.

You must be familiar with a number of different payment systems and fee schedules to properly bill supplies, including the OPPS, the RBRVS physician fee schedule (for rehab), the DME orthotics and prosthetics (for non-implantables), and take home surgical dressing schedules. Knowing which to use and what you can and cannot bill is critical to appropriate reimbursement and compliance.

This intermediate-level program will help you learn how to obtain appropriate fee schedules payment for medical and surgical supplies. Our speakers explain how the fee schedules payment supplements OPPS, strategies to set up appropriate charges in your chargemaster, and examples of appropriate supplies charge tickets.

TAKE A LOOK AT OUR AGENDA

Supply categories

• Medical/surgical supplies
• Durable medical equipment (DME)
• Implantable and non-implantable orthotics, prosthetics, devices and other implants
• Take-home surgical dressings

Conflicting guidance on chargable v. non-chargeable supplies

• Medicare and the non-provision of definitive guidance
• Individual fiscal intermediary guidance

Supply categorization issues

• Ancillary v. non-ancillary supplies
• Billing for separate outpatient fee schedule payment of various supplies
• Orthotics and prosthetics provided to inpatients
• Non-covered supplies
• Documentation to support supply charges
• Special C-code requirements and device/procedure OCE edits
• Revenue code assignment for Medicare, third-party payers

Charging for supplies

• Charge development formulas and consistent charging
• Tiered/graduated charging formulas
• Cost reporting and cost-to-charge ratios

Compliance pitfalls

• Definition of key terms
• Not charging and billing for non-covered items

Billing/reporting examples

A question and answer session will follow the presentation.

LEARNING OBJECTIVES

At the end of the audioconference, you will be able to:

• describe supply benefit categories often overlooked by hospitals
• state how to stay in compliance with supply charging rules
• demonstrate how to set up supply categories in the chargemaster
• show how to submit correct UB-04 claims for supplies

NEW PARTICIPATION OPTION

In addition to the regular participation options for HCPro audioconferences—live, audio tape, audio CD, or combination packages—we are pleased to offer a new option, an audio archive. Audio archive allows you to download the program and play it back at your convenience through your computer or MP3 player.

YOUR MATERIAL PACKET

A materials package containing the slide presentation is provided with PDF links.

MEET THE SPEAKERS

Valerie A. Rinkle, MPA,is revenue cycle director for Asante Health System in Medford, OR. She has more than 20 years of healthcare reimbursement experience including 11 years in nationwide consulting to hospitals and physicians on Medicare and Medicaid payment systems and compliance. She is a the author of numerous articles on OPPS and hospital-based clinics, and a member of the editorial advisory board for the APC Answer Letter and the APC Weekly Monitor, both from HCPro.

Duane C. Abbey, PhD, CFP, is president of Abbey & Abbey Consultants, Inc., in Ames, IA. He has more than 20 years experience with healthcare payment systems, coding, billing, reimbursement, and associated compliance issues. He is the author of Nonphysician Providers: Guide to Coding, Billing, and Reimbursement, Emergency Department Coding and Billing: A Guide to Reimbursement and Compliance, and Chargemasters: Strategies to ensure accurate reimbursement and compliance, all from HCPro.

WHO SHOULD LISTEN?

HIM billers, chargemaster coordinators, finance and revenue cycle managers, and compliance officers in acute care hospitals, wound care clinics, and long term care facilities. Coding staff, HIM directors and coders may also find the program of interest.

Purchase a tape, CD, or audio archive of the program and listen when you can. It's also a perfect training tool for new staff or as a refresher for veteran staff.

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