Wiki What DOS to bill sleep studies & 24 hr Holter?

[KarenMBG]

I work as an outpatient facility coder-- Help!!

When pt comes in for a 24hour holter test, the charge dos is the day they come in to be hooked up. The data/report is the next day--24hr-- should the charge dos be changed to the next day when the report is read? The report does not state a 24 hr period. It is more of an assumption, is this necessary any way?

I have the same problem with sleep studies, overnight tests. The department enters the charge dos as the day the patient came in. The study report can be read up to week or more, the MD will enter the date of service as the date the report was entered. So the charges and report dos have a span between them.. No one can give me guidance on this question-- Should the charge dos and the sleep study dos be the same?

I was informed by my previous manager outpaient services should have the same dos for the charge and the documentation ie report. Are these exceptions? No one has an answer. Current manager has no coding experience to help.

 

[Pam Warren]

Per CPT and CMS.....services are to be reported on the date they are performed. This means that your technical charges (such as a sleep study) are billed out on the date the patient climbs into the bed, and the technician begins to record the data.

The test is not interpreted by the provider on that day, though because of course, the patient continues overnight. Our pulmonary docs don't interpret sleep studies until a day or two later....and that day is their date of service.

Professional/techincal charges don't necessarily have to match if the professional charge is expected to be done at a later date, as with diagnostic studies that require an interpretation and report. We have our reports set up so that we capture the date of the study and the date of the interp/report.

 

[KarenMBG]

Thank you Pam. This is a big help. To bill for the technical side(facility), I have to wait for the report for the diagnosis. The sleep study reports do not have the date of the study, just the providers' interpretation. That would be great to have both dates. Maybe we can do this also. We just converted to a new system and this is a possibility to change the process to include both the study and the interp dos.