Wiki Charging facility fees

[JM.Geyer]

Hello all fellow coders,

we have a dispute here in my office as to wheither we can charge a facitliy fee or not. We work in an outpatient hospital setting and the three of us coders feel we can charge a facilty fee when the patient comes in for and E/M and has labs or imaging done on the same day. However we are being told we can't even if we append the modifer 25.

 

[Chanke]

I think there is more at stake here. Are you licensed as a provider based clinic? Are you Critical Access (CAH)? I think we need more details on this. In some cases yes you can, and in others you cannot at all.

 

[mitchellde]

Hello all fellow coders,

we have a dispute here in my office as to wheither we can charge a facitliy fee or not. We work in an outpatient hospital setting and the three of us coders feel we can charge a facilty fee when the patient comes in for and E/M and has labs or imaging done on the same day. However we are being told we can't even if we append the modifer 25.

the hospital E&M is the facility charge. If the patient comes in just for labs then you have performed no function beyond what they were suppose to receive so there is no facility E&M. If they come to the clinic to see the physician and are then sent to the lab you may charge a facility E&M and the lab. Who is saying you cannot do this?

 

[MRKOCUREK]

Who are you - Are you a physician or hospital. If you are providing technical services, you absolutely can bill, but if you are professional(physician), than obviously, you cannot