Hi Robert-
You need two separate billing numbers (Procedure Codes) in B/AR and a query
answered by Nursing - Does this patient have ESRD? Then write a Keyword in
PHA looking at the query and have a PHA Rule "re-set" the billing number and
put a comment in the Rx Comment field as a note.
[f z esrd.patient]^ESRD,
"Billing Code changed to ESRD J-CODE"^MSG,
"Epo ESRD"^RXCMT,
IF{ESRD="Y" [f rx set billing code]("41012010"),
([f rx set rx comment](RXCMT)),
([f rx msg](MSG));
1};
Works very well - the catch is adding the query for Nursing to answer...and
if you can sneak in a required query without them knowing, it's a done deal.
Best of luck - Kevin.
PS - For most facilities, the dollar amount comes from PHA so remember the
"alternate procedure code" will have to have a dollar amount and get updated
too.
Kevin McConnell, PharmD.
Clinical Consultant
(713)480-6810
[EMAIL PROTECTED]
www.RPhInformatics.com
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
On Behalf Of Brennan, Robert
Sent: Wednesday, October 18, 2006 1:38 PM
To: [email protected]
Subject: [MEDITECH-L] epoetin j-code
Does anyone have some insight they would like to share concerning how
epoetin
billing is handled. I know that there are two J-Codes associated with the
drug, one for ESRD and one for Non-ESRD. As the code is based on diagnosis
and as diagnosis and J-Codes can not be modified on the PHA side, I'm not
sure how this can be handled. Is there a rule out there that selects the
code
based on diagnosis?
Thanks
Bob
Robert Brennan RPh
St Joseph Health Services of Rhode Island
Department of Pharmacy
200 High Service Ave
N. Providence, RI 02904
(401) 456-3522
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