Blog/ Hospital billing
How do you identify one or more access routes?
Learn the CBHPM rules for valuing multiple interventional procedures. This post explains the percentage increases in physician fees according to the approach method used on different organs or structures
- By
- Rivio, Editorial team
- Published
- Reading time
- 2 minutes
I would like to know how, when a procedure is performed, I can tell whether it used a single access route or different access routes. I always have doubts about billing procedures.
Rivio answers
When two or more interventional procedures are performed through the same access route, their valuation must follow item 4 of the CBHPM General Instructions, provided there is no specific code covering the set of acts performed.
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When the approach to multiple organs, regions or joint structures through the same access route is planned in advance, or indicated during the surgical act, the tier assigned will be the one corresponding to the highest-tier procedure. To this value, 50% of the tier set for each of the other medical acts performed must be added, provided there is no specific code for the set.
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In cases where interventions are performed through different access routes, the equivalent of 70% of the tier of each of the other acts performed must be added to the tier of the main procedure.
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When two different teams perform different surgical acts simultaneously, each team must receive the tier corresponding to the procedure it actually performed.
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When a surgical act is an integral part of another procedure, the valuation must consider only the main act, and the tiers are not added together.
