In response to the statement below: BAR Module The revenue codes associated to these procedures are unable to be billed as a Recurring (RCR) account thus creating the need for a 2nd account number for the 2nd day of the protocol. Therefore, we would need to bill two separate procedure charges under 78464 for each day with the coinciding 78478 and 78480 along with the injections.
Why can't you have these revenue codes on a recurring account? Each CPT can print on the claim as a separate line item if set up to do so. Also, what is appearing in fields 6A and 6B (and corresponding ANSI loop/segment) for dates of service? If they need to indicate the two day span, then there are claim checks to pull the first service date and the last service date of the procedures onto the claim. If you could be more specific as to why you cannot have these rev codes on a recurring account, the B/AR piece of this can be better addressed. Thanks, Barbara J. Eaton Senior Implementation Specialist Perot Systems, Inc. ________________________________ From: [EMAIL PROTECTED] on behalf of Lori Gokey Sent: Fri 11/24/2006 4:53 AM To: Julie Carlson; Zydonik, Teresa; [email protected] Cc: Crawford, Kim; Shaffer,Stephen; Costan,William; Hawley, Lisa Subject: RE: [MEDITECH-L] Cardiolyte Stress Tests that follows a 2 dayprotocoldue to obese patients Teresa, I agree with Julie on this. We have several studies in Nuclear Medicine that are two - three day studies. We use the same visit number as they truly are a continuation of the original study and do not need a new V number each time they come in. The radiologists read the nuclear study when it is complete. The stress portion is read upon its completion by cardiology department. In B/AR, we use a CLI account and roll all charges onto the one account. How do you handle I-123 scans/uptakes? Or a 3 phase bone scan - many times, this is a two day study? I am currently a clinical analyst but five years ago I was a director of Nuclear Medicine. I came to the hospital I am at and set up scheduling - if you have pending issues, please don't hesitate to call - I understand both sides very well. Thanks Lori Lori Gokey, MS, CNMT, RT (R)(CT)(N) Clinical Systems Analyst Alice Hyde Medical Center 133 Park Street, P. O. Box 729 Malone, New York 12953 (518) 481-2549 [EMAIL PROTECTED] ________________________________ From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Julie Carlson Sent: Tuesday, November 21, 2006 11:52 AM To: Zydonik, Teresa; [email protected] Cc: Crawford, Kim; Costan, William; Shaffer, Stephen; Hawley, Lisa Subject: RE: [MEDITECH-L] Cardiolyte Stress Tests that follows a 2 dayprotocol due to obese patients Hi Teresa, We're Magic 5.5, but I think the issues are probably the same. We have had our hospitalists doing 2-day Cardiolyte studies (as well as some other Nuc Med studies such as Indium scans and thyroid uptake and scans that sometimes span 2 to 3 days) for quite some time now. Our stress test protocols call for a 2-day study if a male exceeds 250# and a female exceeds 200#. Our schedulers book using a set with the same account number, because the second day is a continuation of the same study. The hospitalist who performs the stress test dictates a report for the treadmill (or Persantine stress test), and then after the Nuc Med part of the study is completed and resulted, the consulting cardiologist dictates an imaging report. We bill under one account number for the Myocardial-SPECT-Multiple (78465), the perfusion with EF (78480), the stress test (93015) and then the isotopes/radiopharmaceuticals. We have never had an issue with using only one visit number......I could go on, but ! if you have any specific questions, I'd be happy to try and help. Julie Carlson Meditech Systems Analyst Cascade Valley Hospital and Clinics 330 S Stillaguamish Arlington, WA 98223 (360)435-2133 ext 5017 [EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]> ________________________________ From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Zydonik, Teresa Sent: Thursday, November 16, 2006 11:00 AM To: [email protected] Cc: Crawford, Kim; Shaffer, Stephen; Costan, William; Hawley, Lisa Subject: [MEDITECH-L] Cardiolyte Stress Tests that follows a 2 day protocoldue to obese patients Meditech L Users, We are a C/S 5.4 Rel 3 version of Meditech. My Radiology and Cardio Staff are in need of some answers and would like to know how other hospitals are handling the following: How is everyone handling when an obese patient is to receive a cardioloyte stress test/MUGA Scan? According to our Cardiologists these type of patients would need to follow a 2 day protocol. The first day the patient would have a resting nuclear study with injection. The second day the patient will return to Cardio for a stress test and will follow up with another nuclear study with injection. In the past these studies were able to be completed in one day and the codes were 78465 Multi Study with 78478 Infraction and 78480 Wall Motion along with the Stress Test Code and contrast media. Scheduling/Admission Module The schedulers would need to book to different accounts numbers since this is over a two day span. This could be handled in the SCH module by asking the patient their weight and if they are obese then the schedule must remember to book two appointments. We currently have these appointment types set up as a SET. I am not aware of any system functionality that the system would create 2 accounts based upon a set. So this would have to be a manual trigger based upon the weight of the patient. BAR Module The revenue codes associated to these procedures are unable to be billed as a Recurring (RCR) account thus creating the need for a 2nd account number for the 2nd day of the protocol. Therefore, we would need to bill two separate procedure charges under 78464 for each day with the coinciding 78478 and 78480 along with the injections. How is anyone else handling this billing? ITS/Report Issue. The Cardiologist will then need to dictate a two day protocol report associated to the first day Account. You can only associate the req seq numbers from the first Account. You can not associate the second day rec seq numbers because they are on a different account and the doctor does not want to dictate two reports. The only option I see would be to copy the report that is associated to the 1st account before it is signed and add it to the second day account which would make the Cardiologist sign this report twice. Does anyone have a different solution to this type of protocol? Any help would be greatly appreciated. Thank-you in advance. Teresa Zydonik I.S. Director ACMH Hospital One Nolte Drive Kittanning,PA 16201 (724)-543-8594 - Phone [EMAIL PROTECTED] - Email (724)-543-8535 - Fax ****************************************************************************** DISCLAIMER - Email is not considered secure. Confidentiality risks are assumed by choosing to communicate with Cascade Valley Hospital and Clinics by email. The information contained in this e-mail is confidential, privileged, or otherwise protected from disclosure. It is intended only for the use of the authorized individual as indicated in the e-mail. Any unauthorized disclosure, copying, distribution or taking of any action based on the contents of this material is strictly prohibited. Please do not rely on e-mail to communicate health concerns or confidential information. 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