Current through Register Vol. 46, No. 39, September 25, 2024
[ 3270 ]
(a) 7010 LABOR AND DELIVERY SERVICES
(1) Function. Labor and Delivery services are
provided by specially trained personnel to patients in Labor and Delivery,
including prenatal care in labor, assistance in delivery, postnatal care in
recovery, and minor gynecological procedures, if performed in the Delivery
suite. Additional activities include, but are not limited to, the following:
Comforting patients in the labor and delivery and
recovery rooms; maintaining aseptic techniques; preparing for deliveries and
surgery; cleaning up after deliveries to the extent of preparation for pickup
and disposal of used linen, gloves, instruments, utensils, equipment and waste;
arranging sterile setup for deliveries and surgery; preparing patient for
transportation to delivery room and recovery room; enforcing of safety rules
and standards; monitoring of patients while in recovery.
(2) Description. This cost center contains
the direct expenses incurred in providing care to maternity patients in labor,
delivery, and recovery rooms. Included as direct expenses are: salaries and
wages, employee benefits, supplies, purchased services, other direct expenses,
and transfers.
(3) Standard Unit of
Measure: number of procedures. Report multiple births as one procedure. Include
Caesarean sections only when they are performed in delivery room. Caesarean
sections performed in the Surgical suite shall be included in the operating
room statistics. Stillbirths are counted as procedures. Infants born outside
the hospital building are not to be classified as a procedure unless care was
rendered in the Labor and Delivery Services. Whenever obstetrical and
gynecological procedures such as abortions, D & C's, etc. are performed in
Labor and Delivery, each procedure performed is counted as one.
(4) Data source. The number of procedures
shall be an actual count obtained from medical records, or as maintained by
Labor and Delivery.
(b)
Surgical Services Group.
(1)
7040 SURGERY
SERVICES..........................................................................................................
7041 General
Surgery..........................................................................................................
7042 Open Heart
Surgery..........................................................................................................
7043
Neurosurgery..........................................................................................................
7044 Orthopedic
Surgery..........................................................................................................
7045 Kidney
Transplant..........................................................................................................
7046 Other Organ
Transplants..........................................................................................................
7049 Other Operating Room
Services..........................................................................................................
(i) Function. Surgical Services are
provided to inpatients, and outpatients if the hospital uses a common operating
room for both inpatients and outpatients, by physicians and specially trained
nursing personnel who assist physicians in the performance of surgical and
related procedures during and immediately following surgery. Additional
activities include, but are not limited to, the following:
Comforting patients in the operating room; maintaining
aseptic techniques; scheduling operations in conjunction with surgeons;
assisting surgeon during operations; preparing for operations; cleaning up
after operations to the extent of preparation for pickup and disposal of used
linen, gloves, instruments, utensils, equipment and waste; assisting in
preparing patients for surgery; inspecting, testing and maintaining special
equipment related to this function; preparing patient for transportation to
recovery room; counting of sponges, needles and instruments used during
operation; enforcing of safety rules and standards.
(ii) Description. These cost centers contain
the direct expenses incurred in providing surgical services to patients. When a
common operating room is used for both inpatients and outpatients, the direct
costs for both are to remain in this cost center. Included as direct expenses
are: salaries and wages, employee benefits, professional fees, supplies,
purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of
surgery minutes. Surgery minutes is the difference between starting time and
ending time, defined as follows:
Starting time is the beginning of
anesthesia administered in the room in which the procedure is to be performed
(or surgery if anesthesia is not administered or if anesthesia is not
administered in the operating room).Ending timeis the end of
surgery.
(iv) Data source.
The number of surgery minutes shall be an actual count obtained from the
operating room log.
(2)
7060 RECOVERY SERVICES
(i) Function. Recovery
Services are provided by specially trained personnel immediately following
surgery, including monitoring of patients while recovering from anesthesia.
Additional activities include, but are not limited to, the following:
Comforting patients in the recovery room, maintaining
aseptic techniques, monitoring of vital life signs, operating of specialized
equipment related to this function, administering specified medication,
observing patient's condition until all effects of the anesthesia have passed,
preparing patient for transportation to acute care or intensive care
units.
(ii) Description.
This cost center contains the direct expenses incurred in monitoring of
patients while recovering from anesthesia. Included as direct expenses are:
salaries and wages, employee benefits, professional fees, supplies, purchased
services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of
recovery room minutes. Recovery room minutes is the difference between time of
admission to recovery room and time of discharge from the unit.
(iv) Data source. The number of recovery room
minutes shall be an actual count maintained by the recovery room.
(3) 7080 ANESTHESIOLOGY
(i) Function. Anesthesia services are
rendered in the hospital by, or under the direction of, either a physician
trained in anesthesia or the operating surgeon. Additional activities include,
but are not limited to, the following:
Recording kind and amount of anesthetic administered;
conducting physical examination of patients; observing patient's condition
until all effects of the anesthesia have passed; obtaining laboratory findings
before anesthetic is administered; administering treatment to patients having
symptoms of post-anesthetic complication; accompanying patient to recovery room
or intensive care unit; prescribing pre- and post-anesthesia medication;
establishing and carrying out safeguards for administration of
anesthetics.
(ii)
Description. This cost center contains the direct expenses incurred in
administering anesthetics under the direction of a physician. Included as
direct expenses are: salaries and wages, employee benefits, professional fees,
supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of
anesthesia minutes. Anesthesia time begins when the anesthesiologist begins to
prepare the patient for the induction of anesthesia in the operating room or in
an equivalent area, and ends when the anesthesiologist is no longer in personal
attendance, that is, when the patient may be placed under post-operative
supervision.
(iv) Data source. The
number of anesthesia minutes shall be an actual count maintained by the
Anesthesiology cost center.
(c)
Medical Supplies and Equipment
Group.
(1) 7110 MEDICAL SUPPLIES SOLD
(i) Description. The Medical Supplies Sold
cost center is used for the accumulation of the invoice cost of all medical and
surgical supplies sold directly to patients. The invoice/inventory cost of
nonchargeable supplies and equipment issued by the Central Services and
Supplies cost center (Account 8460) to other cost centers shall be reported in
the using cost centers. If medical and surgical supplies are sold in other
hospital cost centers, the cost of those items must be reported in to this cost
center. The overhead cost of preparing and issuing medical and surgical
supplies and equipment sold directly to patients must be reported in the
Central Services and Supplies cost center (account 8460). The applicable
portion of such overhead will be allocated to this cost center during the cost
allocation process. The cost of reusable patient chargeable supplies must be
reported in the Central Services and Supplies cost center. Do not report in
this cost center the cost of durable medical equipment sold, leased or rented.
Such costs are to be reported in accounts 7130 and 7140, Durable Medical
Equipment-Sold, and Durable Medical Equipment-Leased/Rented,
respectively.
(ii) Standard unit of
measure: none required; not applicable.
(iii) Effective date. Relative to the
separation of Durable Medical Equipment (accounts 7130 and 7140) from this cost
center, the effective date is cost reporting periods beginning in 1982 and
thereafter.
(2) 7130
DURABLE MEDICAL EQUIPMENT-SOLD
..........................................................................................................
(i) Description. The Durable Medical
Equipment-Sold cost center is used to report the invoice/inventory costs of all
durable medical equipment sold directly to patients. Durable Medical Equipment
includes but is not limited to: hospital beds, wheelchairs, trapeze bars,
oxygen tents, intermittent positive breathing machines, etc. Include in the
appropriate Home Program Dialysis cost center the cost of dialysis and
supportive equipment sold. The overhead cost of preparing and issuing durable
medical equipment sold directly to patients and others must be reported in the
Central Services and Supplies cost center (account 8460).
(ii) Standard unit of measure; none required;
not applicable.
(iii) Effective
date. Reporting periods beginning in 1982 and thereafter.
(3) 7140 DURABLE MEDICAL
EQUIPMENT-LEASED/RENTED
..........................................................................................................
(i) Description. The Durable Medical
Equipment-Leased/Rented cost center is used to report depreciation expenses
related to the durable medical equipment leased or rented directly to patients
and others. Durable medical equipment includes but is not limited to: hospital
beds, wheelchairs, trapeze bars, crutches, canes, oxygen tents, intermittent
positive breathing machines, exercycles, heat lamps, flotation mattresses, bed
baths, etc. Include home program dialysis equipment and support in the
appropriate Home Program Dialysis cost center. The overhead cost of preparing
and issuing durable medical equipment leased and rented to patients and others
must be reported in the Central Services and Supplies cost center (account
8460).
(ii) Standard Unit of
Measure; none required; not applicable.
(iii) Effective date. Reporting periods
beginning in 1982 and thereafter.
(d) 7150 DRUGS SOLD
(1) Description. The Drugs Sold cost center
is used for the accumulation of the invoice/inventory cost of all
pharmaceuticals, intravenous solutions and blood derivatives sold directly to
patients. The invoice/inventory cost of non-chargeable drugs (pharmaceuticals,
blood derivatives and I.V. solutions) issued by the Pharmacy (account 8470) to
other cost centers shall be reported in the using cost centers. If such items
are sold in other cost centers, the cost of those items must be transferred to
this cost center. The overhead cost of preparing and issuing drugs sold
directly to patients must be accumulated in the Pharmacy cost center (account
8470). The applicable portion of such overhead will be allocated to this cost
center during the cost allocation process.
(2) Standard Unit of Measure: none required;
not applicable.
(e)
Laboratory Services Group.
(1)
7210 LABORATORY
SERVICES-CLINICAL..........................................................................................................
7211
Chemistry..........................................................................................................
7212
Hematology..........................................................................................................
7213 Immunology
(Serology)..........................................................................................................
7214 Microbiology
(Bacteriology)..........................................................................................................
7215 Procurement and
Dispatch..........................................................................................................
7216 Urine and
Feces..........................................................................................................
7219 Other Clinical
Laboratories..........................................................................................................
(i) Function. These cost centers
perform diagnostic and routine clinical laboratory tests necessary for the
diagnosis and treatment of hospital patients. Additional activities include,
but are not limited to, the following:
Transporting specimens from nursing floors and
operating rooms; drawing of blood samples; caring for laboratory animals and
equipment; maintaining quality control.
(ii) Description. These cost centers contain
the direct expenses incurred in the performance of laboratory tests necessary
for diagnosis and treatment. Included as direct expenses are: salaries and
wages, employee benefits, professional fees, supplies, purchased services,
other direct expenses, and transfers.
(iii) Standard Unit of Measure: workload
measurement units. Laboratory Workload Recording Method,
published by College of American Pathologists (use the latest edition). In
recording Workload Measurement Units, workload units related to quality control
standards, calibration standards and specimen collection, duplicates and
repeats for which a patient is not charged are not to be counted. Workload
units for unlisted procedures should be reasonably estimated based upon work
units for other comparable procedures, or estimated by qualified personnel.
Workload measurement units shall be maintained and reported for laboratory
services obtained from outside laboratories.
(iv) Data source. The number of workload
measurement units shall be an actual count maintained by the
laboratory.
(2) 7230
LABORATORY SERVICES-PATHOLOGICAL
..........................................................................................................
7231
Cytology..........................................................................................................
7232
Histology..........................................................................................................
7233
Autopsy..........................................................................................................
7239 Other Pathological
Laboratories..........................................................................................................
(i) Function. These cost centers
perform diagnostic and routine laboratory tests on tissues and cultures
necessary for the diagnosis and treatment of hospital patients. Additional
activities include, but are not limited to, the following:
Mortuary operation, autopsy; transportation of
specimens from nursing floors and operating rooms; care of laboratory animals
and equipment; maintenance of quality control standards; preparation of samples
for testing.
(ii)
Description. These cost centers contain the direct expenses incurred in the
performance of diagnostic and routine tests on tissues and cultures. Included
as direct expenses are: salaries and wages, employee benefits, professional
fees, supplies, purchased services, other direct expenses, and
transfers.
(iii) Standard Unit of
Measure: workload measurement units. Laboratory Workload Recording
Method, published by College of American Pathologists (use the latest
edition). In recording Workload Measurement Units, workload units related to
quality control studies, calibration standards and specimen collection, and
repeats for which a patient is not charged, are not to be counted. Workload
units for unlisted procedures should be reasonably estimated based upon work
units for other comparable procedures, or estimated by qualified personnel.
Workload measurement units shall be maintained and reported for laboratory
services obtained from outside laboratories.
(iv) Data source. The number of workload
measurement units shall be an actual count maintained by the
laboratory.
(3) 7250
WHOLE BLOOD AND PACKED RED CELLS
(i)
Function. This cost center procures and collects whole blood and packed red
cells. Also included in the recruitment of donors.
(ii) Description. This cost center contains
the direct expense incurred in procuring whole blood and packed red cells,
drawing blood and recruiting and paying donors. Included as direct expenses
are: salaries and wages, employee benefits, professional fees, supplies,
purchased services and other direct expenses. Do not include in this cost
center the expenses incurred in performing tests on blood
(
i.e., typing, crossmatching, etc.). These expenses must be
reported in Laboratory Services-Clinical (account 7210). The cost of blood
derivatives is to be reported in account 7150, Drugs Sold (if the patient is
charged), or the using cost center (if the patient is not charged).
The cost of blood (amount paid or fair market value) is
reported in this cost center, or an inventory account if applicable, rather
than netted against revenue or cleared through an agency account. When blood is
purchased, cost is the amount paid. The service fee charged by the outside
blood sources is not reported here but reported in Blood Processing and Storing
(account 8480). When blood is donated, cost is its fair market value at the
date of donation and an offsetting amount is reported in Donated Blood (account
5770).
If replacement blood is received by the hospital blood
bank, the original amount charged the patient is reported in this cost center
and removed from the patient's account (Accounts and Notes Receivable, account
1030).
(iii) Standard Unit
of Measure: workload measurement units. Laboratory Workload Recording
Method, published by College of American Pathologists (use the latest
edition).
(iv) Data source. The
number of workload measurement units shall be an actual count maintained by
this cost center.
(4)
7260 BLOOD PROCESSING AND STORING
(i)
Function. This cost center processes, preserves, stores, and issues whole blood
and packed red cells after it has been procured. Additional activities include,
but are not limited to, the following:
Plasma fractionation; freezing and thawing blood;
maintaining inventory control.
(ii) Description. This cost center contains
the direct expenses incurred in processing, storing, and issuing whole blood
and packed red cells after it has been procured. Included as direct expenses
are: salaries and wages, employee benefits, professional fees, supplies,
purchased services and other direct expenses. Include in this cost center the
cost of spoiled or defective blood, and the service fee charged by outside
blood sources, whether or not the blood is replaced. Do not include in this
cost center the expenses incurred in performing tests on blood
(i.e., typing, crossmatching, etc.). These expenses must be
reported in Laboratory Services-Clinical (account 7210). The cost of blood and
packed red cells must be reported in the Whole Blood and Packed Red Cells cost
center (account 7250). The cost of blood derivatives must be in the Drugs Sold
cost center (account 7250) if the patient is charged, or the using cost center
if the patient is not charged.
(iii) Standard Unit of Measure: workload
measurement units. Laboratory Workload Recording Method,
published by College of American Pathologists (use the latest
edition).
(iv) Data source. The
number of workload measurement units shall be an actual count maintained by
this cost center.
(f) 7290 ELECTROCARDIOGRAPHY
(1) Function. This cost center operates
specialized equipment to record graphically electromotive variations in actions
of the heart muscle; record graphically the direction and magnitude of the
electrical forces of the heart's action; and/or record graphically the sounds
of the heart for diagnostic purposes. Additional activities include, but are
not limited to, the following:
Wheeling portable equipment to patients' bedside;
explaining test procedures to patient; operating specialized equipment;
inspecting, testing and maintaining special equipment; attaching and removing
electrodes from patient.
(2)
Description. This cost center contains the direct expenses incurred in
performing electrocardiographic examinations. Included as direct expenses are:
salaries and wages, employee benefits, professional fees, supplies, purchased
services, other direct expenses, and transfers.
(3) Standard Unit of Measure: workload
measurement units. Laboratory Workload Recording Method,
published by College of American Pathologists (use the latest edition).
Workload units for unlisted procedures should be reasonably estimated based
upon work units for other comparable procedures, or estimated by qualified
personnel.
(4) Data source. The
number of workload measurement units shall be an actual count maintained by
this cost center.
(g)
7310 CARDIAC CATHETERIZATION LABORATORY
(1)
Function. The Cardiac Catheterization Laboratory provides special diagnostic
procedures such as catheterization required for care of patients with cardiac
conditions.
(2) Description. This
cost center shall contain the direct expenses incurred in providing cardiac
catheterization diagnostic examinations. Included as direct expenses are:
salaries and wages, employee benefits, professional fees, supplies, purchased
services, other direct expenses and transfers.
(3) Standard Unit of Measure: number of
procedures. Count each cardiac catheterization procedure for which a charge is
made as one procedure.
(4) Data
source. The number of procedures shall be the actual count maintained by the
Cardiac Catheterization Laboratory.
(h) Radiology Services Group.
(1) 7320 RADIOLOGY-DIAGNOSTIC
..........................................................................................................
7321
Angiocardiography..........................................................................................................
7322
Ultrasonography..........................................................................................................
7339
Radiology-Diagnostic-Other..........................................................................................................
(i) Function. This cost center
provides diagnostic radiology services as required for the examination and care
of patients under the direction of a qualified radiologist. Diagnostic
radiology services include the taking, processing, examining and interpreting
of radiography, ultrasonograms, and fluorographs. Additional activities
include, but are not limited to, the following:
Consultation with patients and attending physician;
radioactive waste disposal; storage of radioactive materials.
(ii) Description. This cost center contains
the direct expenses incurred in providing diagnostic radiology services.
Included as direct expenses are: salaries and wages, employee benefits,
professional fees, supplies, purchased services, other direct expenses, and
transfers.
(iii) Standard Unit of
Measure: relative value units. Radiology Relative Values as determined by the
California Medical Association, 1974 California Relative Value
Studies. Relative value units for unlisted and "BR" (By Report)
procedures should be reasonably estimated on the basis of other comparable
procedures or estimated by qualified personnel. (Count "Total Unit Value", not
"PC Unit Value".)
(iv) Data source.
The number of relative value units shall be the actual count maintained by the
Radiology-Diagnostic cost center.
(2) 7340 CT SCANNER
(i) Function. The CT (computed tomographic)
Scanner function provides computed tomographic scans of the head and other
parts of the body.
(ii)
Description. This cost center shall contain the direct expenses incurred in
providing CT scans. Included as direct expenses are: salaries and wages,
employee benefits, professional fees, supplies, purchased services, other
direct expenses, and transfers.
(iii) Standard Unit of Measure: number of
procedures. Count each computed tomographic scanner procedure as one procedure.
Count only those procedures which are charged for. A patient procedure is
defined as the initial scan and any additional scans of the same anatomical
area during a single visit.
(iv)
Data source. The number of procedures shall be the actual count maintained by
the CT Scanner cost center.
(3) 7360 RADIOLOGY-THERAPEUTIC
(i) Function. This cost center provides
therapeutic radiology services as required for the care and treatment of
patients under the direction of a qualified radiologist. Therapeutic radiology
services include therapy by radium and radioactive substances. Additional
activities include, but are not limited to, the following:
Consultation with patients and attending physician;
radioactive waste disposal; storage of radioactive materials.
(ii) Description. This cost center contains
the direct expenses incurred in providing therapeutic radiology services.
Included in these direct expenses are: salaries and wages, employee benefits,
professional fees, supplies, purchased services, other direct expenses, and
transfers.
(iii) Standard Unit of
Measure: relative value units. Radiology Relative Values as determined by the
California Medical Association, 1974 California Relative Value
Studies. Relative value units for unlisted and "BR" (By Report)
procedures should be reasonably estimated on the basis of other comparable
procedures or estimates by qualified personnel. (Count "Total Unit Value", not
"PC Unit Value".)
(iv) Data source.
The number of relative value units shall be the actual count maintained by the
Radiology-Therapeutic cost center.
(4) 7380 NUCLEAR MEDICINE
..........................................................................................................
7381 Nuclear
Medicine-Diagnostic..........................................................................................................
7382 Nuclear
Medicine-Therapeutic..........................................................................................................
(i) Function. This cost center
provides diagnosis and treatment by injectable or ingestible radioactive
isotopes as required for the care and treatment of patients under the direction
of a qualified physician. Additional activities include, but are not limited
to, the following: Consultation with patients and attending physician;
radioactive waste disposal; storage of radioactive materials.
(ii) Description. This cost center contains
the direct expenses incurred in providing nuclear medicine services to
patients. Included as direct expenses are: salaries and wages, employee
benefits, professional fees, supplies, purchased services, other direct
expenses, and transfers.
(iii)
Standard Unit of Measure: relative value units. Radiology Relative Values as
determined by the California Medical Association, 1974 California
Relative Value Studies. Relative value units for unlisted and "BR" (By
Report) procedures should be reasonably estimated on the basis of other
comparable procedures or estimated by qualified personnel. (Count "Total Unit
Value", not "PC Unit Value".)
(iv)
Data source. The number of relative value units shall be the actual count
maintained by the Nuclear Medicine cost center.
(i) 7420 RESPIRATORY THERAPY
(1) Function. Respiratory therapy is the
administration of oxygen and certain potent drugs through inhalation of
positive pressure and other forms of rehabilitative therapy as prescribed by
physicians. This function is performed by specially trained personnel who
initiate, monitor and evaluate patient performance, cooperation and ability
during testing procedures. Additional activities include, but are not limited
to, the following:
Assisting physician in performance of emergency care;
reviving and maintaining patients' vital life signs; maintaining open airways,
breathing, and blood circulation; maintaining aseptic conditions; transporting
equipment to patients' bedsides; observing and instructing patients during
therapy; visiting all assigned patients to ensure that physicians' orders are
being carried out; inspecting and testing equipment; enforcing safety rules;
and calculating test results.
(2) Description. This cost center contains
the direct expenses incurred in the administration of oxygen and other forms of
therapy through inhalation. Included as direct expenses are: salaries and
wages, employee benefits, professional fees, supplies, purchased services,
other direct expenses, and transfers.
(3) Standard Unit of Measure: number of
treatments. Count each procedure for which a charge is made as one treatment.
Oxygen charges would be reported as one per day regardless of service time.
All-inclusive rate hospitals should count treatments as if a charge were to be
made.
(4) Data source. The number
of treatments shall be the actual count maintained by the Respiratory Therapy
cost center.
(j) 7440
PULMONARY FUNCTION TESTING
(1) Function. This
cost center tests patients through measurement of inhaled and exhaled gases and
analysis of blood, and evaluation of the patient's ability to exchange oxygen
and other gases. This function is performed by specially trained personnel who
initiate, monitor and evaluate patient performance, cooperation and ability
during testing procedures.
(2)
Description. This cost center contains the direct expenses incurred in the
performance of patient and laboratory testing necessary for diagnosis and
treatment of pulmonary disorders. Included as direct expenses are: salaries and
wages, employee benefits, professional fees, supplies, purchased services,
other direct expenses, and transfers.
(3) Standard Unit of Measure: workload
measurement units. Laboratory Workload Recording Method,
published by College of American Pathologists (use the latest edition). In
recording workload measurement units, workload units related to quality control
standards, calibration standards, and specimen collection, duplicates and
repeats for which a patient is not charged are not to be counted. Workload
units for unlisted procedures should be reasonably estimated based upon work
units for other comparable procedures, or estimated by qualified
personnel.
(4) Data source. The
number of workload measurement units shall be an actual count maintained by the
Pulmonary Function Testing cost center.
(k) 7460 NEUROLOGY-DIAGNOSTIC
..........................................................................................................
7461
Electroencephalography..........................................................................................................
7462
Electromyography..........................................................................................................
(1) Function. This cost center
provides diagnostic neurology services such as electroencephalography and
electromyography. Specialized equipment is used to record electromotive
variations in brain waves and to record electrical potential variation for
diagnosis of muscular and nervous disorders. Additional activities include, but
are not limited to, the following:
Wheeling portable equipment to patient's bedside;
explaining test procedures to patient; operating specialized equipment;
inspecting, testing and maintaining special equipment; attaching and removing
electrodes from patients.
(2) Description. This cost center contains
the direct expenses incurred in providing diagnostic neurology services.
Included as direct expenses are: salaries and wages, employee benefits,
professional fees, supplies, purchased services, other direct expenses, and
transfers.
(3) Standard Unit of
Measure: relative value units. Diagnostic Neurology Relative Values as
determined by the California Medical Association, 1974 California
Relative Value Studies. Relative value units for unlisted and "BR" (By
Report) procedures should be reasonably estimated on the basis of other
comparable procedures or estimated by qualified personnel.
(4) Data source. The number of relative value
units shall be the actual count maintained by the Neurology-Diagnostic cost
center.
(l)
Therapy Services Group.
(1) 7510
PHYSICAL THERAPY
(i) Function. The Physical
Therapy cost center provides patient evaluation and therapeutic activities,
patient education and home visits. The cost center provides patient evaluations
by performing and interpreting tests and measurements of cardiovascular,
neuromuscular and musculoskeletel functions and establishes treatment programs.
Treatment is administered through the use of therapeutic agents which employ
the physical, chemical and other properties of air, water, electricity, sound
and light. Specific evaluative and therapeutic activities provided by this cost
center include, but are not limited to, the following:
Application of manual and electrical muscle and range
of motion measurement; evaluation and fitting of prosthetic, orthotic and other
assistive devices; functional testing and training; perceptual and sensory
evaluations; planning and executing therapeutic exercise programs for
increasing strength, endurance, coordination and range of motion; gait analysis
and training; instruction and counseling patients and
families.
(ii) Description.
This cost center contains the direct expenses incurred in maintaining a
physical therapy program, including home care. Included as direct expenses are:
salaries and wages, employee benefits, professional fees, supplies, purchased
services, and other direct expenses.
(iii) Standard Unit of Measure: number of
relative value units and patient visits. The standard unit of measure will be
the relative value units developed by the American Physical Therapy Association
(see Part 447 of this Article). The number of relative value units counted per
visit indicates the extent to which the cost center resources were used during
a patient and resident visit. In addition to relative value units, the number
of physical therapy patient visits must be reported. A patient visit is one
appearance of a patient regardless of the number of evaluation, therapeutic and
patient education activities performed during that appearance. Also included as
patient visits are the home visits made by physical therapists. See account
6910 for a definition of home visits.
(iv) Data source. The number of relative
value units shall be the actual count maintained by the Physical Therapy cost
center.
(2) 7530
OCCUPATIONAL THERAPY
(i) Function.
Occupational Therapy is the application of purposeful, goal-oriented activity
in the evaluation, diagnosis and/or treatment of persons whose function is
impaired by physical illness or injury, emotional disorder, congenital or
developmental disability, or the aging process, in order to achieve optimum
functioning, to prevent disability and to maintain health. Specific
occupational therapy services include, but are not limited to, education and
training in activities of daily living (ADL); the design, fabrication and
application of orthoses (splints); sensorimotor activities; the use of
specifically designed crafts; guidance in the selection and use of adaptive
equipment; therapeutic activities to enhance functional performance;
prevocational evaluation and training; and consultation concerning the
adaptation of physical environments for the handicapped. These services are
provided to individuals or groups, to both inpatients and outpatients and to
home-bound patients.
(ii)
Description. This cost center contains the direct expenses incurred in
maintaining an occupational therapy program. Included as direct expenses are:
salaries and wages, employee benefits, professional fees, supplies, purchased
services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of
treatments (1980). Count each procedure as one treatment. In group sessions,
the number of treatments would be equal to the number of patients in the group.
Count only those procedures which are charged for.
(iv) Standard Unit of Measure: number of
relative value units (1981). The standard unit of measure will be the relative
value units developed by the American Occupational Therapy Association and is
used at the association's request (see Part 447 of this Article). Relative
value units for unlisted procedures should be reasonably estimated on the basis
of other comparable procedures or estimated by qualified personnel.
(v) Data source. The number of treatments
shall be obtained from an actual count maintained by the Occupational Therapy
cost center.
(vi) Effective date.
Relative to the Standard Unit of Measure for this cost center, the relative
value units developed by the American Occupational Therapy Association will be
effective July 1, 1981. For 1980 reporting purposes, report the "Number of
Treatments" in accordance with the above definition.
(3) 7550 SPEECH-LANGUAGE PATHOLOGY
(i) Function. This cost center provides and
coordinates services to persons with impaired functional communication skills.
This includes the evaluation and management of any existing disorders of the
communicative process centering entirely or in part on the reception and
production of speech and lang age related to organic and/or nonorganic factors.
Professional services provided by this cost center are group-ed into a minimum
of three major areas: Diagnostic Assessment and Evaluation-including clinical
appraisal of speech, voice and language competencies, through standardized and
other tests, to determine need for and types of rehabilitation required;
Rehabilitative Treatment-including planning and conducting treatment programs,
on an individual or group basis, to develop, restore or improve communicative
efficiency of persons disabled in the processes of speech, voice and/or
language; and continuing Evaluation/Periodic Reevaluation-including both
standardized and informal procedures to monitor progress and verify current
status. Such activities may be coordinated with medical evaluation and
treatment of hospitalized patients. Additional activities include, but are not
limited to, the following: preparation of written diagnostic, evaluative and
special reports; provision of extensive counseling and guidance to
communicatively handicapped individuals and their families; and maintaining
specialized equipment utilized in evaluation and treatment, such as auditory
training instruments and speech-production prostheses.
(ii) Description. This cost center contains
the direct expenses incurred in maintaining a Speech-Language Pathology cost
center. Any expenses related to the sale of speech prostheses or other
communication aids must not be included here, but accounted in the Medical
Supplies Sold cost center. Included as direct expenses are: salaries and wages,
employee benefits, professional fees, supplies, purchased services, other
direct expenses, and transfers.
(iii) Standard Units of Measure: number of
sessions. Count each evaluation and each treatment session for which there is a
charge as one session. For group activities, count as one session each patient
participating in the session. Also included are sessions with home-bound
patients.
(iv) Data source. The
number of sessions shall be obtained from an actual count maintained by the
Speech-Language Pathology cost center.
(4) 7570 RECREATIONAL THERAPY
(i) Function. Recreational Therapy services
include the employment of sports, dramatics, arts and other recreational
programs to stimulate the patients' recovery rate. Additional activities
include, but are not limited to, the following:
Conducting and organizing instrumental and vocal
musical activities and directing activities of volunteers in respect to these
functions.
(ii) Description.
This cost center contains the direct expenses incurred in maintaining a program
of recreational therapy. Included as direct expenses are: salaries and wages,
employee benefits, professional fees, supplies, purchased services, other
direct expenses, and transfers.
(iii) Standard Unit of Measure: number of
treatments. Count each procedure for which a charge is made as one treatment.
For group activities, count as one treatment each patient in group.
(iv) Data source. The number of treatments
shall be obtained from an actual count maintained by the Recreational Therapy
cost center.
(5) 7580
AUDIOLOGY
(i) Function. This cost center
provides and coordinates services to persons with impaired peripheral and/or
central auditory function. This includes the detection and management of any
existing communication handicaps centering in whole or in part on the hearing
function. Some of the activities of this cost center are: audiologic assessment
(including basic audiometric testing and screening, examination for site of
lesion, nonorganic hearing loss and various parameters of auditory processing
abilities essential for communication function); hearing aid evaluation,
selection, orientation, adjustment and other technical related services; and
audiologic habilitation and rehabilitation including the development,
remediation or conservation of receptive and expressing language abilities.
Such activities are coordinated with medical evaluation and treatment of
hospital patients. Additional activities include, but are not limited to, the
following:
Demonstrating and evaluating amplification devices and
alerting systems; evaluating excessively noisy environments, writing special
reports; providing extended counseling and guidance; inspecting, testing and
maintaining special equipment.
(ii) Description. This cost center contains
the direct expenses incurred in maintaining an Audiology cost center. The
expense related to the sale of hearing aids must not be included here but
accounted in the Medical Supplies Sold cost center. Included as direct expenses
are: salaries and wages, employee benefits, professional fees, supplies,
purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of
procedures. Count each procedure for which a charge is made as one procedure.
Based on the recommendations of the American Speech and Hearing Association,
these procedures should include audiometric screening and identification; basic
audiologic testing (including pure tone and speech threshold tests, speech
disrimination tests and basic impedence tests); audiologic evaluation for site
of lesion (including Bekesy audiometry, tone decay tests, loudness balance
tests, special impedence tests, SISI test, distorted speech tests, competing
speech tests and other measures of peripheral and central auditory structures);
audiologic evaluation for nonorganicity; pediatric audiologic assessment
(including conditional response audiometry, play audiometry, and soundfield
response assessment); electrophysiologic audiologic measures (including
electroencephalographic, brainstem and electrocochleographic procedures);
hearing aid evaluation and selection; audiologic hibilitation (including
hearing aid orientation, counseling, analysis of auditory processing abilities,
auditory and visual communication training, speech, language and hearing
therapy); and audiologic technical services including hearing aid adjustment,
electroacoustic evaluation, noise survey, special report writing,
etc.).
(iv) Data source. The number
of procedures shall be obtained from an actual count maintained by the
Audiology cost center.
(6) 7590 OTHER PHYSICAL MEDICINE
(i) Function. Other Physical Medicine
includes educational and therapeutic activities related to the treatment,
habilitation and rehabilitation of patients with neuromuscular and
musculoskeletal impairments. Include milieu therapy in this cost center. Such
activities are those not required to be included in the Physical Therapy,
Occupational Therapy, Speech-Language Pathology, Recreational Therapy and
Audiology cost centers.
(ii)
Description. This cost center contains the direct expenses incurred in
providing physical medicine activities not specifically required to be included
in another cost center. Included as direct expenses are: salaries and wages,
employee benefits, professional fees, supplies, purchased services, other
direct expenses, and transfers.
(iii) Standard Unit of Measure: number of
treatments. Count each procedure for which a charge is made as one
treatment.
(iv) Data source. The
number of treatments shall be obtained from an actual count maintained by the
Other Physical Medicine cost center.
(7) 7670 PSYCHIATRIC/PSYCHOLOGICAL SERVICES
..........................................................................................................
7671 Individual
Therapy..........................................................................................................
7672 Group
Therapy..........................................................................................................
7673 Family
Therapy..........................................................................................................
7674 Biofeedback
Training..........................................................................................................
7675 Psychological
Testing..........................................................................................................
7676 Shock
Therapy..........................................................................................................
7689 Other Psychiatric/Psychological
Services..........................................................................................................
(i) Function. This cost center
provides psychiatric and psychological services such as individual, group and
family therapy to adults, adolescents and families; biofeedback training;
psychological testing; and shock therapy.
(ii) Description. This cost center contains
the direct expenses incurred in providing psychiatric and psychological
services. Included as direct expenses are: salaries and wages, employee
benefits, professional fees, supplies, purchased services, other direct
expenses, and transfers.
(iii)
Standard Units of Measure: number of treatments. Count each procedure for which
a charge is made as one treatment. For group sessions, count as one treatment
each patient participating in the session.
(iv) Data source. The number of treatments
shall be obtained from an actual count maintained by this service.
(m) 7710 RENAL
DIALYSIS..........................................................................................................
7711
Hemodialysis..........................................................................................................
7713 Peritoneal
Dialysis..........................................................................................................
7715 Patient Dialysis
Training..........................................................................................................
7719 Other
Dialysis..........................................................................................................
(1) Function. Renal Dialysis is the
process of cleaning the blood by the use of an artificial kidney machine or
other method. Additional activities include, but are not limited to, the
following:
Wheeling portable equipment to patient's bedside;
explaining procedures to patient; operating dialysis equipment; inspecting,
testing and maintaining special equipment.
(2) Description. This cost center contains
the direct expenses incurred in providing inpatient and outpatient Renal
Dialysis services in the hospital. Report all Home Program Dialysis expenses in
accounts 6810 and 6820, as appropriate. Included as direct expenses are:
salaries and wages, employee benefits, professional fees, supplies, purchased
services, and other direct expenses.
(3) Standard Unit of Measure: number of
treatments. Count each treatment for which a charge is made as one treatment
regardless of the length of the treatment.
(4) Data source. The number of treatments
shall be the actual count maintained by the Renal Dialysis cost
center.
(n) 7730 KIDNEY
ACQUISITION
(1) Function. This cost center
acquires, stores and preserves all human kidneys for eventual transplantation.
Unlike other ancillary services, the total cost of kidney acquisition is not
accumulated in any one patient care cost center. Therefore, only the costs
which are not properly includable in another cost center are to be included in
this cost center.
(2) Description.
This cost center contains the direct expenses incurred in acquiring, storing
and preserving human kidneys. Included as direct expenses are: salaries and
wages, employee benefits, professional fees, supplies, purchased services,
other direct expenses, and transfers.
(3) Standard Unit of Measure: number of
kidneys acquired. Count each kidney acquired as one.
(4) Data source. The number of kidneys
acquired shall be the actual count maintained by the Kidney Acquisition cost
center.
(o) 7750 OTHER
ORGAN ACQUISITION
(1) Function. This cost
center acquires, stores and preserves all human organs (except kidneys) for
eventual transplantation. Unlike other ancillary services, the total cost of
organ acquisition is not accumulated in any one patient care cost center.
Therefore, only the costs which are not properly includable in another cost
center are to be included in this cost center.
(2) Description. This cost center contains
the direct expenses incurred in acquiring, storing and preserving human organs.
Included as direct expenses are: salaries and wages, employee benefits,
professional fees, supplies, purchased services, other direct expenses, and
transfers.
(3) Standard Unit of
Measure: number of organs acquired. Count each organ acquired as one.
(4) Data source. The number of organs
acquired shall be the actual count maintained by the Organ Acquisition cost
center.
(p) 7910 OTHER
ANCILLARY SERVICES. This cost center contains the direct expenses incurred in
providing ancillary services other than those required to be included in other
specific cost centers. Included are expenses incurred in providing formal
education to school age psychiatric inpatients. Related revenue must be
included in the Other Ancillary Services revenue center (account 4910).
Included as direct expenses are: salaries and wages, employee benefits,
professional fees, supplies, purchased services, other direct expenses, and
transfers.
