• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Pre-Op billing requirements for facility?

Create Wiki Sort by votes
A

ahodge90

Networker
Messages
74
Location
Ashland, MO
Best answers
0
Good afternoon,

I need to ask for some help with something.
I was recently asked to look into what is allowed to be billed for a facility when it comes to pre op visits. I am aware of can be be done on the pro-fee side on this, but I am curious if the same rules would apply in a facility setting.

Any help on this would be greatly appreciated!
 
0
What could be separately billable from the inpatient facility claim is going to vary by each insurance companies, including Medicare. The insurance company I work for typically has a clause in our facility contracts, which indicates any outpatient care within 3 days (or 72 hours) of an inpatient admission, if the pricing for the inpatient claim is based on a DRG, is included in the DRG allowance for the inpatient admission.

So, you are going to need to review each of your contracts and then determine if the inpatient admission facility allowance is based on a DRG allowance or not.
 
You must log in or register to reply here.
Top