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Billing In PCRRT

Billing In PCRRT. Timothy E. Bunchman Professor Pediatrics. Paying attention to detail. Hospital Equipment Pharmacy Nursing PICU Dialysis. Physician Critical Care Nephrology ? Surgery. Costs/Charges associated with PCRRT. Hospital Cost Equipment. Equipment Machinery

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Billing In PCRRT

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  1. Billing In PCRRT Timothy E. Bunchman Professor Pediatrics

  2. Paying attention to detail

  3. Hospital Equipment Pharmacy Nursing PICU Dialysis Physician Critical Care Nephrology ? Surgery Costs/Charges associated with PCRRT

  4. Hospital CostEquipment • Equipment • Machinery • Depreciation over time • Disposables • lines • hemofilters

  5. Hospital CostPharmacy • Solutions • Industry made • Pharmacy produced • Change in drug dosing due to increase clearance • TPN losses • Heparin, Citrate, Calcium

  6. Hospital CostNursing • Isolated Critical Care Programs • start up time • continuous care time • Programs supported by both Dialysis staff and Critical Care staff • start up time (done by dialysis staff) • continuous care time (done by Critical Care staff)

  7. Physicians Charges • Isolated Critical Care programs • Access placement • Prolonged constant attendance • Dialysis Charge • Programs by both Dialysis and PICU • Access placement (PICU charge) • Prolonged constant attendance (PICU charge) • Dialysis Charge (Nephrology Charge)

  8. CPT codes for Physician Charges • Access Placement • 36488 (< 2 yrs of age) • 36489 (> 2 yrs of age) • Prolonged Constant Attendance • 99356 initial 30-74 minutes • 99357 each additional 30 minutes and can include the last 15 minutes of the visit for the day

  9. CPT codes for Physician Charges • Dialysis Charges • Hemodialysis • 90935 with single evaluation of patient • 90937 with multiple evaluations of patient • CRRT/Peritoneal Dialysis • 90945 with single evaluation of patient • 90947 with multiple evaluation of patient

  10. How can Nephrology affect (positively) PICU admissions

  11. More patients on CRRT means more PICU patients Pt #

  12. Conclusion • Unfortunately, billing is an issue that cannot be ignored • CRRT is a modality that serves patients well • PCRRT has potentially hidden avenues that will allow for capturing of charges in order to support a PCRRT program

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