bsholar

Just received my price list last Friday. To quote my rep: Modest increase in gel reagents. Significant increase for everything else." Sticker shock doesn't begin to describe my reaction! I am also interested in how our group pricing compares to others.

CMS specifies which HCPCS codes allow separate billing for freezing and thawing services. However, it also states that "hospitals may bill the appropriate freezing/thawing CPT code(s) if a frozen/thawed blood product is not transfused, regardless of whether the product's HCPCS code is included in the list...In this scenario, hospitals may not bill the blood product P-code or the transufsion CPT code can be billed. For unused frozen/thawed blood, OPPS providers should bill the appropriate freezing and/or thawing CPT code(s) on the date when the hospital is certain the blood will not be transfused. " Keep in mind, this terminology is for the Outpatient Setting, since all Inpatient billing is DRG driven. And... I'm a simple blood banker, not a coder/billing specialist. We usually can reallocate a thawed plasma to another patient within the 24 hour expiration, so have very little waste and do not worry about the above scenario.

CMS allows the charging for splitting, pooling, thawing of product in preparation for transfusion. If the unit is not transfused, you cannot charge the standard product fee. See the "Comprehensive Guide to Billing and Reimbursement Update" pages 16 & 17 for specific examples on how to code and bill. Just be careful not to charge the splitting fee with the remaining unit of a split ( only 1 split fee can be charged if unit was divided in half, only 2 split fees if divided in thirds). We use one on one education about the platelets - making sure the physician understands that they must be transfused. Our supplier works with us to redistribute in cases where the patient expires or is transferred before shipment arrives.

We are on V6.2, and our component types are all defined into basic LR, LRI (LR IRAD), PLR1, PLR2 etc. I did the same with the ISBT-128 coding for two reasons: Ease of component type recognition by techs and nursing staff, and billing - our codes match HPCS / CPT descriptions.