CARDIAC CATH CHARGE CAPTURE

We are in the middle of changing the hospital methodology for charging cardiac cath procedures within EPIC CUPID - can you provide your insight -

What is the work flow for Cardiac Cath procedure charging for your Hospital:

  1. Time increments?  And HIM provides CPT codes by documentation and integrates to charge?

  2. Procedure? Each CPT code is detailed with specific charge and the department posts ?  Maybe HIM validates accuracy?

  3. Procedure?  Each CPT code is detailed with specific charge and HIM posts based on documentation

 

Thank you for your time.

Andrea

 

Comments

  • We use the McKesson system for our Cath Lab, and tried a multitude of processes, but have nailed one down after our initial year of implementation. Right now our coding accuracy is at 100% with our audits.

    We hard coded all of our procedures for the Cath Lab, when initially were soft coding. I have measured each CPT code against the fee schedule for Medicare, to ensure our pricing is capturing the full potential of our reimbursement. The department is where the most training had to take place, as we rely upon the staff to drop the appropriate procedure charge for what was performed. Our HIM departments reviews documentation, then validates if we have the correct CPT codes and charges being reported. If not, then they communicate with my Revenue Integrity staff, and my staff will drop the appropriate charge, so that it doesn't have to go all the way back to the Cath Lab for review. Revenue Integrity then reviews for devices, to make sure we have captured all of the documented stents, caths, or pacemakers for the procedure. If any of the supply charges are missing, we contact the Cath Lab to drop the charge for the devices. 

    None of the CPT codes for Cath Lab are time based, is the reason behind why we went with the fee for service. Also, some diagnostic procedures reimburse around $2,500, so didn't want to have any time based charges skyrocketing our contractual adjustments. 
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