You Be the Coder:
Billing for Supplies
Published on Mon Oct 01, 2001
Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: Our physicians want to bill for a new bone-marrow tray. But we are a clinic, and the physician performs biopsies in our local hospital. The hospital does not use this supply. Can we order these trays, take them to the hospital, and then bill for them from our facility?
Arizona Subscriber
|
Answer: Although you must pay for the bone-marrow trays, you will not be able to bill for the tray used to do a procedure outside of the office.
Once the physician leaves his or her office to perform a procedure, the billing process changes.
At best, physician-performed procedures done within in a facility become the jurisdiction of both the physician and the facility. When a procedure is performed in the hospital, the hospital has the right to bill for the technical component, fees related to the procedure. The technical portion covers hospital costs needed to cover the room, support staff and related medical surgical supplies. The bone-marrow tray can also be billed by the hospital because this supports the technical process; however, these are not always reimbursed. The physician, on the other hand, can bill only the professional component of procedures performed in a hospital or other inpatient facility.
In this example, the physician practice should bill 85102 (bone marrow biopsy) with modifier -26 (professional component).
Because the tray is considered part of the technical component, the physician is unable to bill for the bone- marrow tray even though the physician brought the tray from his or her office. | |
