1. Billing and Charges for CRRT
Andree V. Gardner
Pediatric Nephrology, Dialysis and Transplantation
DeVos Children’s Hospital
Grand Rapids, MI
PCRRT ~ June 26, 2004

2. Capturing both is the key!
Types of Charges
Physician (Current Procedural Terminology)
Intensivist
Nephrologist
Facility (Charge Description Master)
Nursing Time
Support Staff Time
Supplies
Capturing both is the key!

3. Physician ~ Intensivist CPT’s
More than 25 to choose from
Common CPT’s are:
, , , , , ,
*A detailed list will be available at
Current Procedural Terminology = CPT

4. Physician ~ Nephrologist CPT’s
90945 Single Evaluation of hemofiltration or other continuous renal replacement therapies
90947 Multiple Evaluation of hemofiltration or other continuous renal replacement therapies.

5. Physician Billing Tool
Billing Cards
Able to customize for each division
Size of a shirt or coat pocket
With the CPT Codes and abbreviated description
Patient Name, Date of Visit and Diagnosis Boxes
Example will be at
***DOCUMENTATION***

6. Facility Billing Factors
Nursing Time
Support Staff Time
Supplies Needed
Equipment Maintenance & Depreciation

7. Nursing Average time for machine set-up and initiation of therapy
Straight time or overtime
Daily Bed Fees
Shift differentials
Additional bonuses

8. Support Staff Time Clerical & Stock-keeper
What do these people contribute to the facility charge? Small tasks that add up to dollars that drive the cost per treatment!
Input charges
Process physician and pharmacy orders
Order & Maintain stock

9. Supplies Filters Lines Gloves Masks Needles Syringes Saline Heparin
Or sets with both items
Gloves
Masks
Needles
Syringes
Saline
Heparin
Gauze
What else do you use?
Office Supplies
Forms
Account for all the items that cost you $$$$$$$$$$$$$

10. Facility Billing (Charge Description Master)
Create CDM’s to reflect your facilities' billing protocols
In those CDM’s capture what you are really using in your treatments
Be sure the billing office is using the proper revenue codes

11. Facility Billing Line Item Billing Example Bundled Billing Example
CRRT Set-Up
CRRT Filter
09876 CRRT Lines
Bundled Billing Example
49546 Initiation of CRRT

12. Facility Billing
Either method works as long as you are diligent in determining your costs on an annual basis
And what ever you do……………….

13. DO NOT Throw away YOUR revenue!

14. Thank you!