Compare the HCPCS codes for the procedure against the lists of "inclusions" on the
Consolidated Billing transmittal (available on AANAC site--type word consolidated
billing in search box under document library). The HCPCS for outpatient surgical
procdures are different than the other EXCLUSIONS. The codes listed on the
transmittal for Oupatient Surgery and Related Procedures is INCLUSIONS. That means
that if you find the HCPCS code of the procedure that your resident had on the list of
codes, it is your facility's responsibility to pay. IF the HCPCS code is NOT on the
list, it is not the facility's responsiblity. As always, if you have questions about
this, contact your fiscal intermediary for clarification.
Debridement is often done in SNFs, so may not be an Exclusion, depends on the HCPCS.
-----Original Message-----
From: "Vogt, Kathy" <[EMAIL PROTECTED]>
Sent: Apr 8, 2004 6:13 AM
To: [EMAIL PROTECTED]
Subject: Who pays for surgical debridement?
> -----Original Message-----
> From: Vogt, Kathy
> Sent: Thursday, April 08, 2004 8:13 AM
> To: '[EMAIL PROTECTED]'
> Subject:
>
> I had a med a pt who is going to a wound clinic in a hospital. We have
> recieved bill for OR minor which was for surgical debridement, lab costs,
> and clinic charges. Since surgical debridement is beyond our scope of
> practice in the nursing facility, would this not be able to be billed by
> the hospital. I don't believe this should have been billed to us, should
> it?
>
>
>
> Kathy Vogt
> St Mary's Manor
> Blue Springs, MO
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/----------------------------------------------------------
The Case Mix Discussion Group is a free service of the
American Association of Nurse Assessment Coordinators
"Committed to the Assessment Professional"
Be sure to visit the AANAC website. Accurate answers to your
questions posted to NAC News and FAQs.
For more info visit us at http://www.aanac.org
-----------------------------------------------------------/
/----------------------------------------------------------
The Case Mix Discussion Group is a free service of the
American Association of Nurse Assessment Coordinators
"Committed to the Assessment Professional"
Be sure to visit the AANAC website. Accurate answers to your
questions posted to NAC News and FAQs.
For more info visit us at http://www.aanac.org
-----------------------------------------------------------/
