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Linked Premiums To Parent Codes

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Question:

I'm trying to figure out when I need to link to the parent code. When I bill a premium (e.g. C991), that will need to be linked to the parent code of C415. but what if I've done a procedure (e.g. a colonoscopy)? we get paid depending on the segment we reach - so if I bill Z496, does this have to be linked to E740 (e.g. splenic flexure) or can I bill them all separately? Do biopsies for a colonoscopy need to be linked to the colonoscopy performed?

Answer:

The parent premium checkboxes are meant to calculate the % premiums. Since you are using C991 and E740, both are "fixed price", so you don't really need to use them. However, best practice is to have the checked, so that it is clearly showing.. as such, here's our recommendation:

Link the C991 with the A415 (note: you can't bill C415 + C991.. always A41X + C premium for inpatient, or A41X + K premium for admission). Link the E740 with Z496.

 

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