Billing Codes and Encounter Forms Billing for Services

Transcription

1 Appointment Type New Patient Audio Billing Codes and Encounter Forms Usually Billing for Services Sometimes Basic Comprehensive PTA (AC only) Audio (AC, BC, SRT, WR); [if no SRT, use ] Tymp + AR AC/BC Tymp+ART+ARD SRT WR Stenger Tone Filt Sp (Quick SIN) Stenger Speech OAEs Dx Tymps ART AR Decay V5010 Assessment for &Selection of Charge Level hearing aid UASP Service Plan; Years V5275 EMI each V5264 Earmold, non-disposable R V5264 Earmold, non-disposable L V5050 ITE Hearing Aid Monaural R V5050 ITE Hearing Aid Monaural L V5060 BTE Hearing Aid Monaural R V5060 BTE Hearing Aid Monaural L HA Consult HANC Hearing aid service, No HA Fitting V5011 Fit/Orient of HA UAMF1 Fit/Orient of earmold V5020 Conformity Evaluation UAA F1 Fit/Orient of accessory Verification (REM) UAHP1 HA Programming: New Settings V5014 Repair/Modification of Hearing Aid HANC Hearing Aid Service, No charge; Level EAA monaural Repeat/Followup Audio EAA binaural PTA (AC) Basic Comprehensive Audio (AC, BC, SRT, WR), WR AC/BC SRT Stenger Tone Filt Sp (Quick SIN) Stenger Speech OAEs Dx Tymps ART

2 HA Follow-up HANC Hearing Aid Service, No charge; Level UAHV1 Conformity Evaluation Validation (ex: COSI) UAHP1 HA Programming: New Settings UAHC1 HA Counseling &Instruction Vocational Rehab Audio and Consult Vocational Rehab HA Fitting Occupational Hearing Screening CO1D CO2F Hearing and device assessment Fitting Fee Pure tone audiometry (threshold); air only **Cannot bill (cerumen) with (basic comp) For level coding, 1 level = 15 minutes of time AR Decay V5014 Repair/Modification of a HA V5020 Conformity Evaluation Verification (REM) EAA monaural EAA binaural HA check monaural HA check binaural UAHP2 HA Programming: Back to Previous Settings Ear Protector Attenuation Measurements

3 Hearing Aid Service Level Coding The clinic uses two codes to account for and, if appropriate, bill for time spent providing hearing aid related services: HANC Hearing Aid Service, No charge, and HAC, Hearing Aid Service, Charge. They should be utilized as follows: (1) When to use: (a) For all hearing aid related clinical services, whether the patient is present or not, including: (i) Hearing aid discussions as part of a hearing evaluation or hearing aid consultation, (ii) All fitting and follow up appointments, and (iii) Preparation for or follow up regarding all hearing aid appointments. (b) Use HANC for: (i) Hearing aid consultations and selection, and (ii) All hearing aid services provided to individuals under a UA Hearing Aid Service Agreement (c) Use HAC for services provided to individuals not under a UA Hearing Aid Service Agreement. (2) How to specify the level: They level selection is intended to represent the complexity of the service. (a) Operationally, this can be defined as the amount of time needed, both while the patient is there and in preparation and follow up of the appointment. In other words, time spent sending off a hearing aid, checking it in, running ANSI, and charting should be included in the level coding. (b) Levels represent increments of 15 minutes: Level 1 = 15 minutes, Level 2 = 30 minutes, etc. If a hearing aid is sent for repair, the time spent evaluating and sending it off should be coded that day. The time spent checking it in, evaluating and programming it should then be coded on the day those services are done.

4 Physician Quality Reporting System (PQRS) In order to both respond to the PQRS requirements and help insure optimal care, the following procedures are to be followed for EVERY patient seen for an audiologic evaluation, irrespective of their method of payment for services, both new and established patients: 1. FRONT OFFICE STAFF: Ask patients to come 10 minutes early and to be prepared to provide medication info. Give patients medication form (attached) to fill out prior to appointment 2. CLINICAL FACULTY: Review medications and use the appropriate PQRS code to indicate that the list is up to date and has been reviewed. THIS IS MANDATORY FOR ALL PATIENTS SEEN FOR EVALUATION. Code appropriately in cases of physical/traumatic deformity of the ear and acute/chronic dizziness. Such patients are to be referred to a physician unless there is a clinical reason for such a referral to be unnecessary. 3. BILLING MANAGER: Enter codes appropriately.

5 Name: Date: Please provide us with the following information regarding your current medications, including prescription, over-the-counter, herbals, vitamin/mineral/dietary (nutritional) supplements. If you have a pre-printed list, we are happy to make a copy of that instead. Medication Dose How Often How Taken Condition Taken For (pill, enhaler, etc)

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