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Register patients correctly in multiple outpatient departments

APCs Weekly Monitor, October 24, 2008

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Q. We have multiple outpatient departments and each of them may share a patient. For example, the same patient can see wound care, hyperbarics, and rehabilitation clinicians. Each department registers the patient with a unique account, but the billing department differs and says that there should be one account number per patient and that each department should register the patient under that number. Which is the correct way to register these patients?

A. Many policies can affect your decision. For example:

• For single non-recurring visit, in a single encounter, you should combine the services into a single claim. For example, a patient receives a laboratory and radiology test during a single visit to the hospital.

• For a recurring service, you must create a series claim. For example, rehabilitation and PT/OT/Speech are repetitive services. The provider should bill each on its own monthly claim separate from other services on the same day; with the occurrence span code 74 (Non-covered level of care/leave of absence—dates represent the period at a non-covered level of care in an otherwise covered stay, excluding any period reported by occurrence span code 76, 77, or 79). Include the date of the other services, to prevent an overlap.

• If you provide two visits on the same day for non-related services, bill each service separately. For example, a patient who has elective outpatient surgery in the morning returns to the ED in the afternoon for an unrelated condition.

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