[MT-L] Miscellaneous test billing in LAB
Diekhans,Kelsy
I’m looking for a better way to handle the way we bill for tests that are not built in our lab module due to infrequent use. If an order comes in that is not in our test dictionary, Lab will order a “miscellaneous test”, which includes a query for the CPT and charge. Each day, I pull the previous day’s miscellaneous test report. Using the View B/AR Procedure dictionary, I search by CPT and find a code that is closest to the price needed. I then add that procedure to the patient’s account in B/AR.
The problem is sometimes there isn’t a perfect match in B/AR so the name may not reflect the actual lab test. I could request a new bill code from our chargemaster, but that might take a few days, which will post a late charge on the account AND the
charge might never be needed again, depending on the rarity of the test.
Does anyone have a better process to bill these tests?
Thanks,
Kelsy Diekhans
Lab Information Systems Coordinator
Benefis Health System
Great Falls, MT
Stephanie Alford
Kelsy –
We have a MISC lab procedure in the BAR procedure dictionary. The billing code for that matches the billing code in LAB. When that is ordered, it is fixed in BAR to have the appropriate CPT code and price that we obtain from the reference lab. That is done within 1-2 days of the draw.
Stephanie Alford
MIS Project Coordinator
Information Systems
Peterson Regional Medical Center
551 Hill Country Drive, Kerrville, Texas 78028
o: 830-258-7572
f: 830-258-7321
sal...@petersonrmc.com
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Julia Carter
That’s typically what I’ve seen in other facilities. I make sure that the claim check zPR BL LIST (this one is MAGIC, but I’ve used similar checks in other versions) is set up on reimbursement management rules and claims in order to hold the account in UB until charges (misc Lab in this case) are completed correctly. (Adding the check to rules and claims is a two-step process to insure that if it’s overridden in one area, it’s caught in the next one.)
I also have a BAR selection report built with the BAR procedure number(s) that auto compiles monthly.
At some hospitals, this is then sent to the Lab to review for volume. If a misc test is used X number of times in XX days, the Lab requests a new procedure code for the CDM and enters it in their billing dictionary. This process has been extremely helpful to make sure all Lab staff are notified of the new charge. I was recently able to identify two users who still used MISC for a charge added 30 days prior, so they were retrained. It’s a great QA tool.
A lot depends on which reference Lab you’re using – sometimes the specific test and charge isn’t known for several weeks, which I don’t think is acceptable, but . . . this is why accounts are held in UB, not dropping the claim to begin aging before it’s actually been sent to the payer.
At my current site, the long-term plans are to use custom select fields in the Biller Work Queue to separate this type of check for each department, then train specific users on the Biller Work Queue functionality, and have the charging department be responsible for revenue integrity.
julia carter, cpar
Senior Management Consultant
Phone 229.891.6668
Jacobus Consulting, Inc. | Achieve What Matters Most™
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Jane Tye
-----Original Message-----
From: Meditech-l [mailto:meditech-...@mtusers.com] On Behalf Of Stephanie Alford
Julia Carter
I love this, Jane! I think it’s the best practice, and the interface with the ref lab is great. I just don’t know if all hospitals can do that.
julia carter, cpar
Senior Management Consultant
Phone 229.891.6668
Jacobus Consulting, Inc. | Achieve What Matters Most™
Alicia Holt Poznanovich
Our process is similar – order MISC test with test information. We actually request billing to place the account on hold if it is outpatient or discharges; otherwise, our chargemaster can usually get the bill code out in time. It does happen on occasion that the test is not used very frequently, but in my experience, once you have a request for a test from a doctor on staff, they usually request it again. Things are a little different for outpatients…
Alicia Poznanovich
LIS Coordinator/CLS
Salinas Valley Memorial Hospital
From: Diekhans,Kelsy [mailto:KelsyD...@benefis.org]
Sent: Thursday, April 21, 2016 9:40 AM
To: medit...@mtusers.com
Subject: [MT-L] Miscellaneous test billing in LAB
I’m looking for a better way to handle the way we bill for tests that are not built in our lab module due to infrequent use. If an order comes in that is not in our test dictionary, Lab will order a “miscellaneous test”, which includes a query for the CPT and charge. Each day, I pull the previous day’s miscellaneous test report. Using the View B/AR Procedure dictionary, I search by CPT and find a code that is closest to the price needed. I then add that procedure to the patient’s account in B/AR.
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Paul P. Assam
HI Kelsey,
We use generic bill codes to submit a miscellaneous test charge. The bill codes are built for the different departments and or charge category. We added a CDS to the bill codes to capture the CPT codes. We scheduled a report to compile the previous days miscellaneous test orders then manually enter the charges.
Email: paul....@holy-cross.com
From: Meditech-l [mailto:meditech-...@mtusers.com]
On Behalf Of Diekhans,Kelsy
Sent: Thursday, April 21, 2016 12:40 PM
To: medit...@mtusers.com
Subject: [MT-L] Miscellaneous test billing in LAB
I’m looking for a better way to handle the way we bill for tests that are not built in our lab module due to infrequent use. If an order comes in that is not in our test dictionary, Lab will order a “miscellaneous test”, which includes a query for the CPT and charge. Each day, I pull the previous day’s miscellaneous test report. Using the View B/AR Procedure dictionary, I search by CPT and find a code that is closest to the price needed. I then add that procedure to the patient’s account in B/AR.
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