Health Information Management

Know when to charge for ancillary bedside procedures beyond the room rate

HIM-HIPAA Insider, January 19, 2015

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Inpatient coding professionals are used to DRG systems where all of the diagnoses and procedures map to a single DRG. So they may not look for additional procedures and services to report outside of that DRG.

 
However, in some cases, coding professionals can—and should—report ancillary services provided to inpatients.
CMS provides little specific guidance on hospital inpatient charging practices in general, which creates plenty of confusion for facilities, says Denise Williams, RN, CPC-H, vice president of revenue integrity services for Health Revenue Assurance Associates, Inc., in Plantation, Florida. Consultants further muddy the waters when they state with authority that something "can't" be billed, even saying they are following Medicare rules, Williams adds.
 
"The payer denies the ancillary services, and then says you can't incorporate that into your room rate," Williams says.
 
Continue reading "Know when to charge for ancillary bedside procedures beyond the room rate" on the HCPro website. Subscribers to Briefings on Coding Compliance Strategies have free access to this article in the January issue.



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