Wiki Wound care billing

[joyceprice]

I work at a critical access hospital and we are starting an outpatient wound care clinic in the hospital. Two physicians will come and treat patients once a week in the outpatient clinic and will bill for their professional services and procedures on their own. The hospital is providing the nursing staff for these visits at our facility as well as front office registration, insurance pre-certifications and such. Can we bill a facility E&M fee for these patient encounters?

 

[lmartien]

CAH Wound Care Billing

Hi, Joyce,

I see where this post is several months old and hope you got an answer to your question. I didn't see one here so wanted to get in touch. I've done wound care coding and billing for the past 15 years, often from CAH facilities.

As with most other facilities, CAH hospitals can bill for an E/M service in addition to the wound are when a separate and distinct service has been provided, just like with any other site of service or procedure performed. Most wound centers I've familiar with have an E/M leveling tool they use to assure they aren't capturing charges that are billed with their own CPT codes. I have a copy of an old one I have attached here.

LindaView attachment Level of Acuity Tool (HOPD) for Wound Care.pdf

 

[ILHC]

wound care

Where are all the places that wound care can be provided? Is it only at the PCP office, hospital, and wound care center?

Thanks

Debbie