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CAPC Palliative Care Discussion Forum
Billing and Finance

Next Reply: Re:Reimbursement
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Post Reimbursement
Author: ceaelle
Date: Apr 13, 2009 3:27 pm
Our Palliative Care program is very new - up and running since April 1. We've had several referrals already. Our Medical Director would like to know what your experience has been with maximizing reimbursement (i.e. avoiding as many denials as possible) - basing billing on time spent or on intensity of services? Thanks!

Christie Moore
Replies: order by [Date] [Author] [Subject]
Re:Reimbursement (by JulieP on 04/14/2009)
Are you billing inpatient and/or outpatient services?
Inpt~ primary issue is PC provider being of same specialty as the attending provider. When this happens and each provider has a separate dx for their service we append the 77 modifier. Example: Attending bills with liver cancer and PC bills for cancer related pain or signs/symptoms. I have the coders append the 77 modifier to both services in the hopes that neither will be denied.
Outpatient~ ocassionally the Medical Oncologist and the PC povider will see the patient on the same day in clinic. We follow the rules as I stated above with the 77 modifier.
Julie Pipke CPC, Reimbursement Mngr MCW
+ Re:Reimbursement (by ceaelle on 04/14/2009)
Thanks for responding! Our physician is the only one in her specialty so I don't anticipate problems with same provider, same day issue. We only see inpatients at this point. Do your physicians base billing on time spent or on intensity of services, using the palliative care diagnoses? Thanks!

Christie Moore

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