Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
CRIP, section 4-2
Certified Revenue Integrity Professional Implants
| Question | Answer |
|---|---|
| How does the FDA define Implant? | A device intended to be implanted into a surgically or naturally formed cavity of the human body to continuously assist, restore or replace the function of an organ system or structure of the human body for 30 days or more. |
| What information must be retained when using an implant? | - Name & address of facility - any ID numbers on the implant or device (lot, batch, model or serial #) used by manufacturer - pt's demographic info - name & demographic info of surgeon and physician following pt's care |
| What are some ways that a facility can evaluate the usage of implants and identify potential savings? | Identify implants/devices that the fac wants to use Work w/ physicians to consolidate contracted vendors to get addt'l savings Work w/ the fac supply chain to negotiate per case pmts w/ vendors review all pmts to ensure compliance and sustained savings |
| How is Anesthesia billed? | - technical component includes the anesthetic itself & and supplies used to administer & overhead costs. Rev code on UB-04 is 037X - Anesthesia. Does not require a HCPCS code. Pmt is considered packaged under OPPS or included in MS-DRG pmt. |
| Conscious Sedation billing: | Appendix G of the CPT manual has a list of procedure codes in which conscious sedation is considered inherent to the proc. so the cost of the sedation should be captured in cost associated with the primary procedure. |
| Recovery Room billing: | billed on UB w/ rev code 071X - Recovery Room No CPT code required as recovery room svcs are considered a related item/svc provided w/ CPT coded proc. CMS recommends to only report recovery room/PACU charges separately if proc was done in an OR. |
| What are some scenarios where you have a "no cost device"? | there's a new device for the physician to sample there's an indigent pt needing the device full or partial credit was provided by manu - sometimes happens when a device was removed and replaced (if it failed during warranty pd or a recall occurred.) |
| Rules for billing a no cost device: | Token charge of $1 or less When billing for replacement device with full or partial credit, use a condition code to explain why it's being replaced. |
| Condition code 49 for replacement device: | The device was not working properly and so was replaced earlier than anticipated (applies when credit is 50% or more) Also needs Value Code FD on both OP and IP cliams w/ amt of device credit. |
| Condition code 50 for replacement device: | The device was recalled by the FDA or the manufacturer and new device replacements are necessary (applies when credit is 50% or more) Also needs Value Code FD on both OP and IP cliams w/ amt of device credit. |
| Condition code 53 for replacement device: | The initial placement of device was provided as part of a clinical trial or free sample. For OP claims that have rec'd a device credit upon the initial medical device placement in clinical trial or free sample. Also use Value Code FD on both OP and IP clm |
| What are the two code families that Cardiac Catheterization CPT Codes are separated into? | - Congenital Heart Disease (CHD) - non Congenital Heart Disease (non CHD) |
| What types of procedures are included in the cardiac catheterization CPT Codes? | - Most injections procedures - Imaging supervision, interpretation and report - Contrast injection to image access site(s) - closure device placement at the vascular access site |
| Lower Extremity Revascularization includes: | - catheterization - road mapping - angiography - surgical procedure code for the intervention - Radiology supervision and interpretation for the intervention - Embolic protection - an open or precutaneous access - an arterial closure device |
| What is an implantable Automatic Defibrillator? | An electronic device designed to detect and treat life-threatening tachyarrhythmias. Consists of a pulse generator and electrodes for sensing and defibrillating. |
| What does MAR stand for? | Medication Administration Record |
Created by:
Amy17349
Popular Medical sets