In April, Labcorp Drug Development, a reimbursement consulting firm, formerly called Covance, presented a webinar on reimbursement for blood products and related services for the American Red Cross Biomedical Services National Headquarters. Labcorp Drug Development has worked with the American Red Cross on reimbursement issues for many years. A recording of the presentation is available on the American Red Cross website.
The presentation provides a broad overview of complex payment systems that are constantly evolving, so Labcorp Drug Development notes that each provider must determine the most appropriate way to bill for products and services. The information presented is specific to Medicare, but Labcorp Drug Development explains that other payers have similar reimbursement policies.
The presentation covers reimbursement fundamentals and provides various scenarios for different billing situations — for blood products and transfusions, patient-specific laboratory services, and irradiated units. The presenter also discusses U.S. Food and Drug Administration platelet guidance and the implications for billing as well as coding for COVID-19 convalescent plasma.
Best practices are also shared and include:
- Determining the setting of care before choosing how to bill.
- Ensuring billing practices comply with Medicare guidelines.
- Always using the same date of service for the transfusion procedure and the blood units.
- Using only the applicable code for the date of service.
- Billing only one unit for the transfusion procedure.
- Never double-billing (e.g., for antigen screening or irradiation).
- Knowing how a hospital handles billing for units that are different from what is ordered.
- Never billing for unused blood.
- Billing for blood processing consistently.
- Setting charges at appropriate levels.
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