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Re: [MedicalBillers] ER visit with surgical supplies

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  • KIMBERLY SIERRA
    We use rev codes in CA but Medi-Cal doesn t look at them for out patient services. Medi-cal in CA is different from any other state. They do thing so backwards
    Message 1 of 17 , Jun 2, 2007
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      We use rev codes in CA but Medi-Cal doesn't look at them for out patient services. Medi-cal in CA is different from any other state. They do thing so backwards to every other ins here. I think of myself as knowing a foreign language when it comes to them. Medi-cal uses rev codes for in/pt but doesn't except all of them. I do agree I would have said 99282 but I also see the points for 99284. Would have liked to see the report and how detailed it was may have helped.

      Kim

      Debbie brosnan <thebiller_2000@...> wrote:
      I didnt realize Ca doesnt use Rev codes. how the heck do you identify the ancillary services? Lab, xray, supplies, drugs, implants, you know the usual stuff that goes along with a normal patient care. I am in Michigan, we have quirky rules too. I have heard that if you can bill in Ca and Michigan you can bill anywhere.

      Ok, here is my question. I am taking the CPC exam in 16 days. there is a scenerio (sorry cant spell) in my practice book that goes like this.

      The patient is brought to the ED with a broken collar bone, The injury was sustained from a fall while rock climbing in the mountains. The dr performs a detailed history and exam. The bone is splinte dwith a firgure 8 splint and the patient is sent home with a prescription of Lortab 7.5 and directions to restrict activity for a few weeks (low decisio making).

      What level would you pick?

      KIMBERLY SIERRA <ms2ks@...> wrote:
      Debbie,

      Thanks again. I also do ER Physician billing. What is your question. As for rev codes because the supplies are being billed under the surgical procedure code with a modifier for supplies the rev code wouldn't be in the 200 range right or wrong? Also Medi-Cal in CA doesn't look at rev codes for out patient billing. But I want to know the correct rev code to link it to for ER. You are luck to have a billers group that gets together. I happen to find this web site by accident but let me say I am glad I found it!

      debbie brosnan <thebiller_2000@...> wrote:
      Kim,

      Supplies dont go on rev code 250. That is a pharamacy code. Use 250 if pt received any drugs. Lactated Ringers or anything administered through IV use 258. Med-Surg supplies go under 270. Sterile supplies use 272. The hospital charge master should have these supplies already linked to the correct Rev Codes.

      Do you do ER Physician billing? or just facility? I have an ER Physician billing question.

      Its always good to be able to bounce questions off of people, we have a state billers group, we meet every 90 days, its a great group of people. Always bouncing stuff off of each other. Everyone knows the insurance company sure isnt going to help us.

      Let me know about the ER question

      Stay on the sunny side of life,

      Deb

      KIMBERLY SIERRA <ms2ks@...> wrote:
      Thank you Debbie Brosnan. That is what I thought would be the correct way to bill the charges out. As for rev codes 450 for ER services? Someone in our thought that the supplies should fall under rev code 250? What do you think?
      Thank
      Kim

      debbie brosnan <thebiller_2000@...> wrote:
      You can bill for both the ED and The procedure since the patient did not come in for the purpose of surgery. Besure to use the correct revenue codes. You can bill for supplies with the correct rev codes for sterile and nonsterile supplies along with drugs. I am not sure if the supplies will be bundled into the APC reimbursment. Be sure to add anesethesia charges if the patient recieved anything other than a local. Did the patient in turn get admitted to recovery? If so besure to add recovery room charge. If the patient recovered in the ED then you cant bill for recovery room. I would treat this the same as a bedside procedure with an ER visit. Please let me know if someone tells you different.

      The physician is going to bill an E/M Mod 25 and the procedure.

      Deb Brosnan, BS

      KIMBERLY SIERRA <ms2ks@...> wrote:
      Hey Everyone,

      I have a question. This has been a heated topic at work. I was wondering if anyone would know where I can find the answer to this question along with documentation. When a patient comes into the ER and the doctor decides to do surgery. Can the hospital bill for a room charge and a separate line for supplies related to the surgery? I am looking for the correct way to bill for Medi-Cal (CA) and Managed Care programs(CA) ? These is for facility charges only the Doc bill will be separate.
      Thanks

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