Coding For Bronchoscopy At The Inpatient Bedside

Quest ion:

If a physician performs a bronchoscopy within an inpatient room, and the patient is an inpatient status, should we charge the CPT® code for bronchoscopy or the hospital facility account?

Answ er:

We refer to our Charge Process-Bedside Procedures paper. Services performed on an inpatient by regularly assigned unit nurses are generally considered part of the room and board daily charge That said, when a physician performs the bronchoscopy at the bedside, the hospital may charge for the technical portion of the procedure. While HCPCScode 31622 describes the service, keep in mind HCPCScodes do not cross over to inpatient claims Hospitals seldom hard-code this procedure on the chargemaster.

To account for the bronchoscopy on the facility side, we suggest a time-based bedside procedure charge under revenue code 0410 - respiratory services

Lidocaine QCF

Quest ion:

How do I figure out a QCFcode for lidocaine NDCnumber 00409-4276-02?

Answ er:

Typically, the database contained in the PARA Dat a Edit or Calculator tab?s ?NDCto J-Code Crosswalk?provides information about the number of units of a HCPCSthat is supplied in a particular vial.

However, our database does not return the total bill units for this particular multidose vial (MDV) NDC, which is unusual. We purchase the data from First Databank, a highly respected pharmacy data vendor (per their website, ?Creating and delivering the world?s most trusted drug databases.?)

This shows how to enter the query on the Calculator tab for the NDCyou mentioned:

Here?s the report result ? although the database that we purchase from First Databank provides the number of units contained in a vial or multidose bottle for most drugs, this NDC report is blank in the ?Bill Units?field ?:

We can figure this out by doing the math, though. In this multi-dose vial, there are 50 milliliters of lidocaine HCL at 1%solution; Lidocaine 1%means a 1:100 dilution, meaning one gram (or 1000 milligrams) in 100 milliliters, or 10 milligrams in each milliliter. Since the HCPCS bill unit description is one unit per 10 milligrams, bill one unit per milliliter administered. We double-checked with the FDA NDCdatabase search, which can be tricky to use. We had to drop the leading zeros to get the query to work; the result confirmed 10mg/ml: https://www.accessdata.fda.gov/scripts/cder/ndc/index.cfm

Please check the above with your pharmacist for confirmation of the calculation.