AHA Coding Clinic® for HCPCS - 2001 Quarter 2; FOR your INFORMATION
Billing outpatient surgical procedures correctly
It is not necessary to bill separate charges for each procedure when multiple surgical procedures are performed at the same session. The following excerpt is from Program Memorandum (PM) Transmittal A-01-50, April 12, 2001: A single charge listed under the revenue code that describes where the procedure was performed (e.g., operating room, treatment room, etc.) is acceptable on the same line as one of the surgical procedure CPT/HCPCS codes. The other procedure would be billed using the appropriate CPT/HCPCS code and the same revenue code, but with zero (0) charges in the charge field. In the past...
Subscribe or sign in to view the full article.
Article Overview
This article discusses outpatient hospital charge reporting when more than one surgical procedure occurs in the same session, including how the billing format changed for emergency room visits and procedures under OPPS-era guidance. It is aimed at hospital billers, coders, and revenue cycle staff who need to understand the general structure of claims reporting, revenue codes, and CPT/HCPCS procedure line placement without combining separate facility services into one charge.
Why This Topic Matters
Correct outpatient claim presentation affects how facility services and procedures are reported on the same encounter, especially when emergency department services and surgical procedures occur together. The topic is important for teams responsible for compliant outpatient charge capture and claim formatting.
What You Will Learn
- How outpatient hospital charges may be reported when multiple procedures are performed in the same session.
- How emergency department visits and surgical procedures are presented as separate outpatient claim lines.
- What kinds of claim-reporting changes were associated with OPPS-era guidance.
- How revenue codes and procedure-code lines relate to outpatient charge reporting.
Who Should Read This
- Hospital coders
- Outpatient billers
- Revenue cycle staff
- Charge capture teams
- Compliance staff
Codes Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com