Author Topic: Billing for In-Home Hemodialysis  (Read 1445 times)

jpositos

  • Newbie
  • *
  • Posts: 22
Billing for In-Home Hemodialysis
« on: August 28, 2015, 01:51:22 PM »
Hi,

We are new in Dialysis billing and this fell on my lap because the Agency owner is a family friend who asked for my help. We have a client in TX insured with BCBSTX and is out-of-network because BCBSTX has no network for Dialysis.  Our client is a HH agency specializing in RN-assisted hemodialysis in patient homes only and provides the RN, DME, supplies and medications needed.  BCBSTX requires that the claims be submitted on a UB04 and not on CMS1500. The previous Biller was billing each treatment 3X a week with G0154 and 90937 plus a list of DME(dialysis machine), supplies used (syringe, bicarb, acid, blood tubing, saline) and medications.  Another bill goes out once a month for all re-supplies (masks, gloves, blood test strips, carbon filters, antiseptics, etc). 

What is the correct way of billing these?  Is there a global way of billing each treatment?

Thank you in advance.

Jocelyn
(310)514-8226

PS - I have Alice & Michelle's book on completing the UB04 and is very helpful.



Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4707
    • Solutions Medical Billing
Re: Billing for In-Home Hemodialysis
« Reply #1 on: August 30, 2015, 04:30:17 PM »
Glad our book was a help.  I wish I had experience in this but I don't.  Hoping someone else on the forum will jump in!
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

jpositos

  • Newbie
  • *
  • Posts: 22
Re: Billing for In-Home Hemodialysis
« Reply #2 on: August 31, 2015, 06:18:12 PM »
I wish too.  There is just not too many resource online that I can find on billing renal dialysis for non-Medicare patients.

Thank you!.

Jocelyn

jpositos

  • Newbie
  • *
  • Posts: 22
Re: Billing for In-Home Hemodialysis - TYPE OF BILL
« Reply #3 on: September 12, 2015, 02:13:44 PM »
Hi Michelle,

My client is a home health agency who provides dialysis in patients home. Based on your book, which code should I use? Are residential homes classified as outpatient or Other? I understand that Field 1 = 3 (home health) but for Field 2, I am torn between 3 (Outpatient) or 4 (Other). If patient is in the Nursing home should I use 6 for residential facility?

Thanks!!

Jocelyn

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4707
    • Solutions Medical Billing
Re: Billing for In-Home Hemodialysis
« Reply #4 on: September 13, 2015, 01:28:09 PM »
The problem is there is no straight answer.  One insurance carrier may require one way while another requires totally different.  In my opinion, I would use 6 for nursing home and 4 for home.
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com