ED Coding and Reimbursement Alert

Question: We are an outpatient wound care center in a hospital setting. Our physicians bill from their own offices, and we input the charges into the hospital system for the hospital partner to do the billing. We bill for clinical sharp debridements on a weekly basis. Should the facility be charging for both an office visit and debridement or should these charges be bundled? Currently the physician and our facility charge for both. Our nurse is present during the debridement but does not perform the procedure. Is this considered double charging?

Vicki Taylor
Curative Health Services, St. Louis, Mo.

Answer: Assuming that your physicians are correctly reporting the place of service as an outpatient hospital on their professional claims, this would not be considered double charging, says Laura Siniscalchi, RRA, CCS, CCS-P, CPC, education coordinator at Beth Israel Deaconess Medical Center in Boston. The physicians claim represents the professional component and the hospitals claim the technical component of the services provided.

Although only the physician is performing the debridement, the room and supplies are being provided by the facility. If the physician were renting office space from the hospital, the physician would report the place of service as the providers office and the hospital would not submit any claim for services provided in the rented office space.