Wiki Hospital billing question

[mfranks]

I have zero experience billing in a hospital setting and I am hoping that somebody can answer my question. In the Hospital Outpatient surgery setting the hospital obviously is billing the technical services under OPPS but can the physician bill for professional services under MPFS?

 

[csperoni]

Yes, of course. The facility bills OPPS and gets paid for the facility portion (covers use of OR, supplies, recovery room, nurse, etc). The physician (surgeon or anesthesiologist for example) bills the CPT performed to Medicare B (or other insurance carrier) for the professional services.

 

[SharonCollachi]

Generally, you're going to bill the same as if the procedure occurred in the office, with the big difference being the Place of Service Code. I tell people if they are not sure of the designation, to call the business office of the facility and ask.

 

[SSweetland]

Is there a good course to take that will teach you setting up surgical procedures and all the charges that are separately billed vs supplies that are part of the APC. Status Indicators, Revenue Codes, Etc. I have attended charge master webinars etc but I am looking for more

 

[SharonCollachi]

Is there a good course to take that will teach you setting up surgical procedures and all the charges that are separately billed vs supplies that are part of the APC. Status Indicators, Revenue Codes, Etc. I have attended charge master webinars etc but I am looking for more

The original question was regarding the physician's portion. Is this a separate question?