Top ten inpatient palliative medicine billing and coding mistakes (and how to fix them this week).

Journal Article (Journal Article)

Palliative care (PC) has undergone incredible growth in the last 10 years, having gained subspecialty status and penetration into 85% of hospitals over 300 beds. The comprehensive services provided by multiple members of the PC team combined with low reimbursement for nonprocedural medical care challenges all PC teams to operate with financial sustainability. Accurately and compliantly documenting and coding services provided to patients can help to maximize PC programs' revenues and limit operating subsidies received from health care systems or hospice programs. In this article we share common billing and coding mistakes made by our programs and colleagues while providing inpatient, consultative palliative care. Each mistake is explained and paired with a straightforward fix to enable compliant, efficient practice. This will allow clinicians to more accurately communicate to payers the complex care provided to inpatients by the PC team. This fuller picture of the complexity of care provided can increase reimbursements received by your PC program from payers. Understanding how to accurately document, code, and receive appropriate reimbursement will allow our field to continue to grow, broadening the reach of PC nationally to improve quality of life for all patients and families in need.

Full Text

Duke Authors

Cited Authors

  • Jones, CA; Bull, J; Acevedo, J; Kamal, AH

Published Date

  • March 2015

Published In

Volume / Issue

  • 18 / 3

Start / End Page

  • 211 - 216

PubMed ID

  • 25671789

Pubmed Central ID

  • PMC4347885

Electronic International Standard Serial Number (EISSN)

  • 1557-7740

Digital Object Identifier (DOI)

  • 10.1089/jpm.2015.0005.18.3


  • eng

Conference Location

  • United States