APS Billing Primer

Weekdays APS billing at SunnybrookBayview & HOAC

• Print extra list in morning before you start rounding for billing. Submit this list once coded to the billing office.

• Only bill for patients actually seen by either yourself or one of the APS NP’s.

• Patients enrolled via OR: APS does not bill the enrollment. The attending in the OR bill C015 and& C101. You don’t bill anything. If patient went to OR while enrolled on APS check with attending if they will be billing any APS codes.

• New consults: Bill either C215 (elective in-patients) or A215 (all (afterother hours)patients). Add C101 if consult done in PACU, CrCu, CVICU, B5ICU, D4, BurnICU orBurnICU, CCU (cardiac ICU). or SCU at HOAC.

• Follow up visits: regardless of modality, bill G247C014 (add C101 for patients in PACU, any nerve catheter including MOTAP and RECTUS SHEATHICU or epidural)SCU orat C012HOAC) for the rest (or A104 over weekend)

• If you insert any blocks on APS patients - please bill blocks codes.codes (G260, G060, G061 +/- G279) accordingly. Add E409 (>1700) or E410 (2400-0700)

• E420 (ISS>15, ASA 4) trauma code also applies to consults/assessments and visits for the first 24 hrs.

• C995 /C987/ C997 premiums are applicable to all after hour’s assessments.

• Only visits to patients with EpiduralsWeekdays after hours are eligible for the assessments:E402 bill premium.A014 plus premiums C962 & C994 (first patient 17:00-2400), C995 (subsequent patients 17:00-2400) or C964 & C996 (first patient 2400-0700), C997 (subsequent patients 2400-0700).

• The individual on pain service is RESPONSIBLE for ensuring services are billed on the change over day (Monday).

WeekendWeekends Acute Pain ServiceAPS Billing

 

Bayview

• bill 

  AllA014+C963+C986 of the above apply AND:

  • Thefor first new patient should be billed with C963 AND C986

  • Subsequent NEW patients should have C987 added

  • Visits to patients with Epidurals – G247 and E402

  • Visits to all other patients A014