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HIM Coders and OR room time charge dilemma. Who should do what and where?

Date: Jun 21, 2021

Question:

I am a CIRCC coder for HIM. I enter the facility CPT codes for the Hybrid room. I enter these codes where the supplies and room time charge is entered. -HIM also has outpatient coders who would enter the CPT codes (only up to the 70,000 series) on a billing side, the side staff would not see. These coders do not code any CPT codes for IR/CV/EP/Hybrid cases; I code and enter them. -The OR billing staff enters their room time charge and says I should not double bill the patient by entering CPT codes; the OR says they “want the HIM outpt coders to enter them” instead on a side not seen. 1) Does it matter who enters the code? This creates a problem in HIM. To keep consistency I want to enter the codes, and the outpt coders want to enter their DX codes. 2) Is there double billing since there is no CPT code for room time? your Q&A #5257 reads “Since the operating room charges time for the surgical procedure performed, all surgical procedures are included in the OR time charge. I don't think that is correct. Please clarify.

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