Health Information Management

Q/A: Correct revenue code for wound care depends on provider, location

APCs Insider, February 19, 2010

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Q: Which revenue code should we use to report wound care, if an occupational therapist or physical therapist performs the service? Which revenue code should we use if a registered nurse performs the services?
 
A: CMS discusses reporting of “sometimes therapy codes” in the Medicare Claims Processing Manual, chapter 4, section 200.9. However, CMS does not dictate which revenue code is applicable for reporting these services when performed as non-therapy services.
 
CMS expects providers to report the service with the appropriate revenue code based on who provided the service and where. A particular department’s mapping in the cost report; the design of a hospital’s individual charging structure, and the requirements of non-Medicare payers affect this decision. Each facility must review the structure and decide which revenue code is most appropriate. Many facilities report these services with 0761 (treatment room) when a qualified nurse provides the service.



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