Description

The teleconference addresses the difficult task of determining how to categorize supply items and devices in the chargemaster.  Due consideration is given to the shifting stance and guidance provided by CMS over the past several years.  Particular attention is given to APCs and associated coding concepts of ‘not reporting separately’ and ‘not to be billed separately’.  Categorization of supply items, including drugs, is a difficult issue for hospital chargemaster personnel.  Also, the use of tiered pricing relative to supplies has led to charge compression and the need for CMS to modify the cost reporting process.  Additionally, the changes that CMS is making to the cost report relative to devices and device definitions lends additional confusion to a difficult topic.

• Why are hospitals concerned about supplies and devices?
• What is all the fuss about hospital charges?
• Why is charge compression such a big deal?
• Why has CMS changed the cost report for expensive devices?
• Why do charges for expensive supplies really matter?
• What is the difference between a routine and non-routine supply item?
• Do DRGs and APCs treat expensive devices fairly for hospitals?
• Are hospitals really allowed to charge separately for everything?
• How can we get inexpensive supply items off the chargemaster?

 Objectives of the session:

• To Review How Supplies and Devices Can Be Categorized
• To Appreciate The Use of Proper Revenue Codes
• To Understand What Supplies Items Are Simply Part of Overhead Expenses
• To Appreciate the Concept of ‘Integral Part’ Supply Items and Drugs
• To Understand CMS’s Guidance Relative to ‘Not Separately Reporting’ and Associated Coding and Claims Filing Processes
• To Appreciate the Pricing Process for Expensive Supply Items and Devices
• To Understand the Impact of Supply Items and Devices on APCs With Particular Attention to Device-Dependent APCs
• To Appreciate Supply Categorization and Associated Pricing Relative to Cost-to-Charge Ratios (CCRs)
• To Appreciate CMS Changes in Definitions of Devices
• To Understand CMS Changes to the Cost Reporting Process to Address Charge Compression with Supply Items and Devices

Agenda of the session:

1. Overview of Supply and Device Categorization
   1. What is a Supply?
   2. Issues Surrounding Supplies
2. Main Supply Categories
   1. Non-Covered
   2. Overhead
   3. Integral Part
   4. Separately Chargeable
   5. Separately Billable/Separately Reportable
3. Chargemaster Development Decisions
   1. Categorizing Supplies, Devices, Drugs, and Biologicals
   2. Pricing and Cost Accounting Concerns
   3. Cost Report Interface to Chargemaster
4. Devices
   1. Changes in Definition
   2. Proper Categorization
   3. Implantable Devices
5. APC Concerns
   1. Charging Versus Billing
   2. Device-Dependent APCs
   3. Supply Categorization Relative to APC Weight Development
6. Compliance Issues
   1. ‘Not Separately Reportable’
   2. ‘Not Separately Billable’
   3. CMS Compliance Concerns
7. Related Cost Report Issues
   1. Cost-to-Charge Ratios (CCRs)
   2. Tiered Pricing and Charge Compression
8. Special Situations
9. Chargemaster Coordinator Action Steps

Who should attend?

• Chargemaster Coordinators
• Billing and Claims Generation Personnel
• Compliance Personnel
• Patient Financial Management Personnel
• Cost Accounting Personnel
• Cost Report Personnel
• Financial Analysts
• Managed Care Contract Personnel
• Revenue Enhancement Personnel
• Chief Financial Officers
• Chief Compliance Officers
• Financial Planners
• All Other Hospital Personnel Interested in Pricing and Proper Billing