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Letter to the editor

Patient Financial Services Weekly Advisor, August 31, 2007

I just read the reply to the question "we recently billed incision of the heart sac as an outpatient..." in the August 10 PFS and disagree with the answer. If the place of service was designated as outpatient in error I suggest that the claim be resubmitted to CMS with a letter of explanation and a copy of the medical records. If the procedure was indeed performed on an outpatient basis then I agree that the charges should be written off.

I have long been a supporter of 'coding' orders with CPT codes so admitting staff can use software that prompts them when a service in designated as inpatient only - that way they can contact the physician to discuss the order and place of service issue. At the least, the provider can print hard copies of the CPT codes designated as inpatient only for use by their admitting staff when there is any question regarding the place of service.

Barbara Aubry, RN, CPC, CHCQM, FAIHQ
Regulatory Analyst
3M Health Information Systems, Inc.

Note: You can read the original Q&A by clicking here.

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