Billing FAQs
From UofL General Peds
Are throat cultures supposed to be included as a separate “result charge,” or on the same encounter?
It should be coded on the day it was performed, even if read 1-2 days later.
What is the correct code for transcutaneous bilirubin?
88720.
Do we need a referring provider listed on the encounter form to bill?
Yes. You must have a referring provider listed for all encounter forms, but CBO will handle this.
For newborns that do not yet have active insurance, can we use Self-pay PENDING since all families should be in the process of applying for insurance rather than Self-pay DISC? Do we have to use Self-pay DISC at all?
Newborns should be the only patients that don’t have active insurance. Please use "self-pay pending," which is FSC 199. If another type of patient does not have have insurance or will never have insurance, it will be self-pay discount FSC 197.
Related to missing charges, are the reports CBO sends weekly issues the coders have caught prior to submitting the bills or those that have been denied and re-examined?
These have not been denied. These are caught before they go out in the claim. They are "near misses." Some are related to provider error, many are due to Allscripts.