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Hospital surgery coder question

Hospital surgery coder question

by Deleted user -
Number of replies: 2

I have a question, but a little background first--

A few months ago, a couple of friends went to a hospital for a doctor’s appointment. They got lost, and at one point, ended up in a large room filled with people working at desks. We assume it was Billers, Coders and/or MTs.

For some reason, it came to mind last night, and I now have a question:

When you’re working for a doctor/surgeon who does both in- and outpatient surgery at a hospital, would you be doing the hospital in- and outpatient coding for him/her, or would the hospital’s coders do it, or does it depend on the hospital? What’s the norm?

Thanks,

Carol

Re: Hospital surgery coder question

by Deleted user -

Carol, there are two parts of the service to consider, the part that pays the facility for use of its rooms, staff, and equipment and the part that pays the surgeon for doing the procedure (the professional charges).  The facility always codes and bills for their part.  The surgeon will code and bill for his professional charges.  They let their staff know they did it, and the staff can get a copy of the operative report to help with that.  

Sometimes, though, the surgeon has an arrangement with the facility for their professional charge coding and billing.  They are still doing it for the surgeon.  

Sometimes, the surgeon may be an employee of the facility.  In that case the facility codes and bills both sides of the service.  You typically see that in federal facilities like the VA, or in HMOs or other healthcare organizations where the physicians and surgeons are paid a salary.  

 

Re: Hospital surgery coder question

by Deleted user -

Thanks, Peggy, for the information. This does clear things up for me.