APS Billing Primer

Print extra list in morning before you start rounding for billing. Submit this list once coded to the billing office. For HOAC, staff in POP clinic is responsible for APS billing.
Patients enrolled via OR: APS does not bill the enrollment. The attending in the OR bill C215+C101. If patient went to OR while enrolled on APS check with attending if they will be billing any APS codes.
New APS consults: Bill either C215 (elective in-patients) or A215 (all other patients). Add C101 if consult done in PACU, CrCu, CVICU, B5ICU, D4, BurnICU, CCU (cardiac ICU) or SCU at HOAC.
Follow up visits: regardless of modality, bill C014 (add C101 for patients in PACU, any ICU or SCU at HOAC)
If you insert any blocks on APS patients - please bill blocks codes (G260, G060, G061 +/- G279) accordingly. Add E409 (>17:00) or E410 (24:00-07:00)
E420 (ISS>15, ASA 4) trauma code also applies to consults/assessments and visits for the first 24 hrs.
Weekdays after hours assessments: bill A014+C962+C994 (first patient 17:00-24:00), C995 (subsequent patients 17:00-24:00) or C964+C996 (first patient 24:00-07:00), C997 (subsequent patients 24:00-07:00).
At Bayview, the individual on pain service is responsible for ensuring all services are billed on the last day of APS e.g. Monday.

Again, enrollments are billed by the attending in the ORs (i.e. A215+C101+C963+986 for first patient, and A215+C101+C987 for subsequent patients)
APS rounds, regardless of modality, bill A014+C963+C986 for the first patient.
Then A014+C987 for each subsequent patient up to 20 patients max.
For patients with catheter / epidural, bill G47+E402 but only after 20 cases of A014+C987 billed (if you visit a patient with catheter more than once, it can be billed up to 3 times per patient per day, but must leave a note each time).
Add C101 for any patient seen in PACU or any ICU.
New APS consults: Bill A215+C987 (note: total time premiums can only be applied to a maximum of 20 patients) and add C101 if consult done in PACU, CrCu, CVICU, B5ICU, D4, BurnICU, CCU (cardiac ICU) or SCU at HOAC.
If you insert any blocks on APS patients - please bill blocks codes (G260, G060, G061 +/- G279) accordingly. Add E409 (weekends/holidays) or E410 (24:00-07:00)
E420 (ISS>15, ASA 4) trauma code also applies to consults/assessments and visits for the first 24 hrs.

APS enrollment billed by each staff in OR: A215+C101+C963+986 for first patient, and A215+C101+C987 for subsequent patients.
For the APS list, HOAC staff #1 bills A014+C987 for first 16 patients (assuming they have billed APS enrollments / consults for the 4 OR cases). HOAC staff #2 bills A014+C987 for the remaining APS patients. Add C101 for those patients in SCU.