Center to Advance Palliative Care

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Billing Tools

A substantial proportion of staff salaries and overhead can be recovered from physician and/or nurse practitioner billing, therefore careful attention must be paid to accurate and comprehensive clinical billing and tracking processes. CAPC has compiled a set of overview documents and tools to assist in the development of proper documentation, coding and billing. These documents focus on Medicare Part B physician and advanced practice nurse billing for those services common to inpatient consult services.

Close collaboration with your local billing experts is a necessity because billing requirements, procedures and some codes may vary across states and institutions. National requirements for coding and billing may change annually or more often, so always consult the CMS Physician Center for specific references.

If you have additional questions, please go to the CAPCconnectTM palliative care discussion forum. CAPCconnectTM is a free resource for health care professionals who want to share information, exchange ideas, and get advice from their colleagues on operational issues affecting their palliative care programs.

2010 CMS Billing Changes
2009 Billing/Coding/CMS Updates
Medicare Claims Processing Manual, Chapter 12
This section of the Medicaid Claims Processing Manual has all the specific requirements for billing by physicians and non-physician practitioners.

Billing and Coding Resources
Coding to Avoid Denial for Same Specialty-Same Day Problems
Avoid Non-Payment for "Same Specialty/Same Day" Problems

Manaker S, Krier-Morrow, D, Pohlig CA, eds. Coding for Chest Medicine 2010: Pulmonary, Critical Care, Sleep. Northbrook: American College of Chest Physicians, 2010.

Center for Medicare and Medicaid Services
Review Articles
Coding Guidelines
Source: Family Practice Management, June 2003

Coding_on_Basis_of_Time
Source: Family Practice Management, June 2003

Sample Billing Documents