Practice Management

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  • 1.  Split Billing for Surgical Codes?

    Posted 09-24-2018 19:30
    Hi All,

    We've been approached about a potential billing scenario and I am not sure what the most appropriate answer would be. 

    If a physician who is not part of a practice comes into one of the practice's offices and performs stereotactic breast biopsies using the practice's equipment, supplies, and staff, is there any way for the practice to split bill for this service?  Since guidance has been bundled into the biopsy code (19081, 19082) I am not sure how we would "split bill".  (The way I am seeing it, the physician would bill for the global service.) 

     

    Thank you!

    Jen

     jmohler@sdil.net



    ------------------------------
    Jennifer Mohler RCC
    Business Operations Manager
    Southwest Diagnostic Imaging, Ltd.
    Phoenix AZ
    (602) 521-6243
    ------------------------------


  • 2.  RE: Split Billing for Surgical Codes?

    Posted 09-25-2018 08:18

    We always recommend that the radiology keep the work for the breast biopsy, even when the codes weren't bundled.   Payment for the procedural code includes the cost of the mammotome device and other supplies that the visiting physician should not be paid for.  Meaning they should not be paid the direct practice expenses for the codes.  I suppose you could figure out how to use the non-facility PE to pay them but then there is also the global malpractice expense to be split as well.  I am not sure why your practice would want to agree to do this.

     

    Pam Kassing, MPA, FRBMA, RCC

    Senior Economic Advisor

    Economics and Health Policy

    American College of Radiology

    1819 Preston White Drive

    Reston, VA 20191

    (800) 227-5463 x4544

     


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  • 3.  RE: Split Billing for Surgical Codes?

    Posted 09-25-2018 10:06

    The physician should bill as professional component and you bill as technical component to capture supplies and equipment usage.  An appeal may be necessary depending on whose charges reach the insurance first.

     

    Thank you,

     

    Monica Witt, CPC | Coding Abstractor III, Radiology

    Physicians Billing Group | UC Irvine Health

    101 The City Dr. South., Orange, CA 92868

    Tel: 714-456-3952 | Fax: 714-456-7359

    e-mail mlwitt@uci.edu

    ucirvinehealth.org

     

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  • 4.  RE: Split Billing for Surgical Codes?

    Posted 09-25-2018 10:30
    We split bill for it at our facility.   Our facility bills tech, room, and supplies separate from the physician's pro fee.  



    Original Message


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