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Billing In PCRRT Timothy E. Bunchman Professor Pediatrics.

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Presentation on theme: "Billing In PCRRT Timothy E. Bunchman Professor Pediatrics."— Presentation transcript:

1 Billing In PCRRT Timothy E. Bunchman Professor Pediatrics

2 bunchman Paying attention to detail

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

4 bunchman Hospital Cost Equipment Equipment –Machinery Depreciation over time –Disposables lines hemofilters

5 bunchman Solutions –Industry made –Pharmacy produced Change in drug dosing due to increase clearance TPN losses Heparin, Citrate, Calcium Hospital Cost Pharmacy

6 bunchman 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) Hospital Cost Nursing

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

9 bunchman Dialysis Charges Hemodialysis with single evaluation of patient with multiple evaluations of patient CRRT/Peritoneal Dialysis with single evaluation of patient with multiple evaluation of patient CPT codes for Physician Charges

10 bunchman How can Nephrology affect (positively) PICU admissions

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

12 bunchman 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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