ques: cath lab staff & billing/coding responsibilities

[jjjoy, LPN]

I'm curious if it's common practice for cath lab staff to be responsible for accurate billing of the services provided. By "accurate billing" I mean selecting all appropriate CPT-code defined procedures done.

I'm asking because where I work, clinical lab staff (nurse, techs) are asked to submit to the hospital charge system all procedures (as defined by CPT codes/rules) incurred during a cath case. Oftentimes, this isn't too big of an extra task. However, when the case isn't just a straightforward, commonly done procedure, the staff often aren't quite sure which procedures to note as there are long lists to choose from, sometimes misleading or vague procedure descriptions and then there are the little quirks required in using CPT codes - such as certain combinations being disallowed.

Anywhere from 2 days to several weeks later, the staff will hear back that this or that wasn't coded correctly. And it's a pain for other departments to have to go back and make changes to incorrect submission. Yet there doesn't seem to be any authority to whom they can turn prior to submitting the charges to determine what's correct. Instead, the lab staff is told that they need to learn all of the different procedures/CPT descriptions so that they can bill correctly.

If this is a common responsibility, how do lab staff fit it in their day? When turning around cases, the lab staff doesn't have time to cross reference a CPT code book in order to find the right procedure description. Do they hope there will be some down time later in the day or enough time after the last case to go back to any cases where they weren't able to identify at the time of the case what the proper code-based procedure description they needed to select for charge purposes?

It seems like the facility is asking the lab staff to be billing/coding experts in addition to competent clinical staff. So I was wondering if this was a common responsibility for cath lab or not.

Thanks!!!!

[dianah, ASN]

I've never been required to do coding or billing.

We collected product stickers on each pt's billing sheet (one per procedure), and that was submitted to our clerical staff, the ones who did the billing.

Don't know how big your dept is, but it seems it would be more efficient to designate one or two ppl to do the coding/billing, and then SEND THEM FOR APPROVED CODING/BILLING TRAINING (with refreshers at specified intervals, determined by those who know when things change).

It seems too much to expect EVERYONE in the Lab to be proficient and accurate in this very important area, without proper training and updates.

Just my two cents.