Q&A: Bill blood administration the same way for inpatient and outpatient accounts
APCs Insider, October 3, 2008
Want to receive articles like this one in your inbox? Subscribe to APCs Insider!
QUESTION: I just heard a fiscal intermediary clearly state that they expect hospitals to bill blood administration on inpatient accounts the same as it is billed on outpatient accounts. Is this correct?
ANSWER: Yes: TriSpan and other FIs and MACs are confirming that hospitals should bill blood administration on inpatient accounts just as they do on outpatient accounts. CMS discusses this in the August 19, 2008 IPPS Final Rule 73 FR 48465. View the last column continuing on to p. 48466.
The rule states:
because blood transfusion and blood products are not specifically mentioned in the definition of ‘routine services’ in the PRM-1 under Section 2202.6, or in the definition of ‘ancillary services’ in Section 2202.8…if the provider does not impose a separate charge in addition to the routine service charge, the service is considered not to be ancillary.
In other words, hospitals are free to create a separate charge for blood administration to inpatients when provided to patients in routine cost centers. They are expected to do so whenever blood is administered in an ancillary department, such as the emergency department, operating room, or infusion center. This step separates the blood administration service from the routine cost center and follows longstanding CMS rules that providers should consistently follow their customary charging practice for all patients, regardless of whether they are an inpatient or an outpatient.
CMS discusses the importance of charging all services consistently between inpatients and outpatients throughout the IPPS Final Rule. The importance will become more apparent as CMS continues its educational efforts on cost reporting and charge practices.
Want to receive articles like this one in your inbox? Subscribe to APCs Insider!
Comments
2 comments on “Q&A: Bill blood administration the same way for inpatient and outpatient accounts ”
- CM (11/30/2012 at 11:39 AM)
- Did anyone ever answer this question for you? I am wondering the same thing. Thank you.
Related Products
-
Billing Alert for Long-Term Care
It's essential to know how to correctly submit your Medicare claims in order to get the reimbursement your facility...
-
The 2013 Medicare Compliance Forum: Las Vegas, NV
-
Medical Necessity 2013: Reduce Risk and Overturn Denials
Facing a lengthy appeals process justifying medical necessity? Our experts show you how to avoid pitfalls and alleviate...
-
Observation Services 2013: Establishing Key Performance Indicators
Deborah Hale helps you evaluate the appropriateness of level of care decision making for observation use and establish key...
-
Inpatient Versus Observation: Apply the 2-Midnight Rule
This session covers the substantial changes CMS has made to the definition of inpatient status and the way hospitals think...
Most Popular
- Articles
-
- CMS seeks comment on quality measures
- Practice the six rights of medication administration
- Note similarities and differences between HCPCS, CPT® codes
- Don't forget the three checks in medication administration
- OB services: Coding inside and outside of the package
- ICD-10-CM coma, stroke codes require more specific documentation
- Nursing responsibilities for managing pain
- Q&A: Primary, principal, and secondary diagnoses
- Skills of effective case managers
- Clearing up the confusion: CPT codes 76376 and 76377
- E-mailed
-
- Coronavirus vaccination: 4 best practices for communicating with patients
- Grievances, Complaints, and Patients’ Rights
- Including 46600 in E/M leveling systems
- Five keys to creating a CHF disease management program
- Fetal non-stress tests represent important part of maternal and fetal health
- Coding, billing, and documentation tips for teaching physicians, interns, residents, and students
- Coding tip: Know how to correctly code each procedure an otolaryngologist can perform on turbinates
- Coding Clinic reiterates guidelines for provider documentation
- CMS creates web portal for questions about 1135 waivers, PHE
- Clarification: Anemia documentation and coding presents communication hazards
- Searched