Report Pump With E Code
Question: A patient received an outpatient orthopedic procedure at our facility, and the physician administered a pain pump. I have heard that I should bill out the supply, but I’m not sure we’ll get reimbursed. What is the best way to bill this in a freestanding ASC?
Pennsylvania Subscriber
Answer: Ultimately, whether you receive reimbursement will depend on what contracts you have with the payer, although most payers do reimburse freestanding ambulatory surgical centers (ASCs) for this supply. You can bill the supply separately, and there are several different possible codes. You will have to choose the appropriate one for the type of pump the physician used.
For example, if the patient required an implantable, non-programmable infusion pump, you would report E0782 (Infusion pump, implantable, non-programmable [includes all components, e.g., pump, catheter, connectors, etc.]). Other pump codes include the following:
· E0779--Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater
· E0780--…for infusion less than 8 hours
· E0781--Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient
· E0783--Infusion pump system, implantable, programmable
· E0784--External ambulatory infusion pump, insulin
· E0786--Implantable programmable infusion pump, replacement
· E0791--Parenteral infusion pump, stationary, single or multichannel.
Quell Patient Anger Over Colonoscopy
Question: During screening colonoscopies, it isn’t unusual for the physician to discover polyps and remove them. We report the procedures with either 45384 or 45385 because while the patients had appointments for screening colonoscopies, that wasn’t the final procedure. The problem: These patients call in and tell us to code screening colonoscopies instead of diagnostic because their FIs pay more for screenings. What should we do?
Florida Subscriber
Answer: Depending on the policy, some insurance companies do pay more for screening colonoscopies than they do for diagnostic ones. But that doesn’t mean you should bow to their requests (via the patient, in this case) to change your coding. If the physician ended up removing polyps, you are correct to scrap G0121 (Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk) and report 45384 (Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor[s], polyp[s], or other lesion[s] by hot biopsy forceps or bipolar cautery) or 45385 (…with removal of tumor[s], polyp[s], or other lesion[s] by snare technique), whichever is more appropriate.
Good idea: Patients become upset because they think the fiscal intermediary (FI) will cover the procedure in full with no out-of-pocket expense. So some facilities have created a letter for patients covered by these FIs that they send out before the patient comes in for the procedure. In the letter, the facility explains the possibility that the screening colonoscopy could become diagnostic, and that in that case, the insurer may not pay. This way, patients aren’t surprised if and when they get a bill for a diagnostic colonoscopy.
Read This Before Reporting 93618
Question: I have a question about the arrhythmia induction code 93618. Is it only for use when a physician tries to induce ventricular tachycardia, or is it for any arrhythmia?
Minnesota Subscriber
Answer: Actually, 93618 (Induction of arrhythmia by electrical pacing) is just for arrhythmia induction. So you can use this code for any type of arrhythmia that the physician tries to induce. Remember, this attempt does not have to succeed for you to use this code. Code 93618 simply tells your payer that the physician attempted the induction.
Reader Questions reviewed by Sarah L. Goodman, MBA, CPC-H, CCP, president of SLG Inc. in Raleigh, N.C.
