Inpatient Bedside Procedures - Charge Separately?

sghany

Would anyone be willing to share if their organization charges bedside procedures separately?

If so, can you provide a list of these procedures and medicare guidelines that are used to charge for such services?

jugnashah

I'm not in a provider organization but can tell you that this is absolutely allowed and more and more hospitals are exploring doing this. Some of the more common procedures that hospitals start with are things like chemotherapy, blood transfusions, PICC line insertions, incision and drainage, lumbar puncture, among others. There are specific ways to go about doing this and there are Medicare citations to help support your efforts to do so. I don't have them off the top of my head but they are in the Provider Reimbursement manual.  What might be useful is to to purchase the webinar the Valerie Rinkle and Denise Williams did for HCPRO on this topic.  Also I believe Denise wrote a small handbook on this topic for HCPRO. Not trying to get you to buy anything but I think these resources come in really handy so that you have everything in one place. 

trosi

We do charge for bedside procedures for OBS and OP in a bed very consistently.  We sporadically charge for them on inpatients due to our inability to find a consistent way to auto charge for them from documentation in our system, Epic.  Currently, we are working with our IT team to compare PB charges of procedures at the bedside to HB charges.  Our first Rev guardian for this is going into production tomorrow!  We have successfully written a rule that will ID the provider's electrical cardiovsersion charge when done at the bedside so that we can apply the HB charge if it was missed. We do have a $flowsheet row where staff is supposed to document the Joules used during the cardioversion for the charge to auto-file, but it is missed a lot.  The new Rev Guardian WQ/rule should help us catch the ones we miss.  Exciting times!

sghany

Thank you both. This is so very helpful.