The Reimbursement User's Guide to Converting HCPCS Codes - On Demand
Recorded On: 04/19/2023
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HCPCS codes are the foundation of billing for home infusion therapy drugs and with all the different billing units (mgs, mls, grams, vials), converting what you are dispensing to the correct billable unit can be a challenge!
Join Rachel Ewell as she helps to ensure you are able to define your HCPCS unit and determine the appropriate billing unit. Ensuring you are billing for the correct HCPCS is integral to being reimbursed appropriately for your services – in this session, you will come away with having an understanding how to determine the correct HCPCS unit for successful billing every time.
This session will cover identifying & defining your HCPCS code and then doing the math to convert into HCPCS units. We will review resources to assist in determining if your drug is a powder, liquid or a vial, what makes up your HCPCS unit and how to bill that finished product. After completing this session, you will understand what unit of measures make up a HCPCS code, when do you need to convert your dispensing unit into a billing unit and how to accomplish this task.
Learning Objectives:
- Define your HCPCS unit so you can convert to billing units.
- When your HCPC unit is powder and you reconstitute it, how do you bill the finished product.
- Understanding the math needed for converting units.
Rachel Ewell
Sr Manager Revenue Cycle
CVS Health
Rachel Ewell has more than a 20 years' experience in home infusion reimbursement. She started her career as a pharmacy technician at OptionCare and quickly realized that she was more interested in being part of the billing team and learning the principles and processes in Revenue Cycle Management. After gaining knowledge and skills at Option Care, Rachel went onto work for the now NHIA President, Connie Sullivan at Heartland IV Care in 2000 in several different roles building the home infusion division from the ground up. Starting in 2013, Rachel took on a consulting role with Reimbursement Concepts working with a variety of different home infusion and DME clients in improving and streamlining their revenue cycle operations. In 2018, Rachel transitioned back into direct AR management working at Coram/CVSHealth as a Senior Reimbursement Manager. Rachel has been actively involved with NHIA for many years including participating in the NHIA Payer Advocacy and Relations Committee since 2011. Rachel also served as a member of the National Government Services Provider Outreach and Education Group from 2012 to 2019. She holds a Bachelor of Arts degree in Social Work.
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