Q/A: Changes to HBO therapy billing
APCs Weekly Monitor, January 7, 2011
Want to receive articles like this one in your inbox? Subscribe to APCs Weekly Monitor!
Q: Did CMS provide any new updates for hyperbaric oxygen (HBO) therapy services for 2011?
A: Based on the 2011 OPPS final rule, HCPCS code C1300 (hyperbaric oxygen under pressure, full body chamber, per 30 minute interval), which falls within APC 0659 (hyperbaric oxygen therapy) with a national unadjusted payment rate of $104.99, did not change.
However, CMS told providers that claims reporting only a single occurrence of the code were anomalies. CMS noted that this was either because the claim reflected a terminated session or because the service was incorrectly coded with a single unit.
Therefore, we urge providers to audit their claims to ensure that:
• Documentation of the service reflects the time of the service
• The units reported reflect the documentation
• The units are reported and submitted correctly based on the actual service time and not defaulted to one because no time increment was documented
Review CMS’ National Coverage Determination for Hyperbaric Oxygen (HBO) Therapy 20.29 for more information.
Editor’s note: Andrea Clark, RHIA, CCS, CPCH, president of Health Revenue Assurance Associates, Inc., in Plantation, FL, answered this question.
Want to receive articles like this one in your inbox? Subscribe to APCs Weekly Monitor!
Related Products
-
Modifier -59 Case Studies: Clarify Common Coding Confusion
Modifier -59 is a perennial problem area for outpatient coders. It shouldn’t be viewed as a way to guarantee payment but...
-
Outpatient Bed Charge Capture: Billing for Common and Complex Cases
During this 90-minute audio conference, our expert speakers walk you through common and complex cases and explain compliant...
-
Billing No-Cost and Low-Cost Devices: Tips to Avoid the Audit Fast Track
During this 90-minute audio conference, our speakers will use a case study to demonstrate best practices to help you comply...
-
Spinal ICD-9 and CPT Coding
During this two-hour audio conference, our speakers will discuss common coding errors for spinal diagnoses and procedures...
-
2012 OPPS Final Rule: Analyze the Impact and Manage the Changes
Expert speakers Jugna Shah, MPH, and Valerie A. Rinkle, MPA, return for this popular program. They review the final rule...
Most Popular
- Articles
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Catch up on what's new with injections and infusions
- Topic: CMS, OESS post new security compliance review information, checklist
- Capturing all necessary codes for IUD insertion and removal can be challenging
- HIPAA Q&A: Level of encryption needed for email
- What does case-mix index mean to you?
- QA:Coding multiple initial infusions
- Identify potential Medicaid RAC target areas
- OB services: Coding inside and outside of the package
- E-mailed
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- HIPAA Q&A: Level of encryption needed for email
- Q&A: Follow CMS' coding guidelines when using modifier -25
- CMS has reformulated payments for some bilateral procedures
- Catch up on what's new with injections and infusions
- New conflicts of interest create new challenges
- Q/A. One injection code or two?
- What does case-mix index mean to you?
- ED-to-inpatient transfers are flawed with safety gaps
- Searched