Picis today announced the immediate availability of an enhancement to its Picis LYNX C/Point® revenue management solution designed specifically for hospital-owned chemotherapy clinics.
LYNX C/Point mitigates the risk of payer and recovery audit contractor (RAC) penalties by providing consistent and compliant charging and revenue capture support for oncology intravenous (IV) clinic administration services, which are part of an oncology patient’s routine treatment. These costly, but undervalued services are under greater scrutiny by the Office of Inspector General because of complex coding rules for infusion and injection procedures. Together with Picis’ LYNX E/Point® solution, C/Point now provides clinics with the tools to calculate accurate and defensible services for their entire outpatient populations, including chemotherapy infusion centers — meeting guidelines issued by the Centers for Medicare and Medicaid Services (CMS), and providing financial predictability of oncology charges that reflect services rendered to patients.
“Oncology IV therapy is even more expensive than routine IV and hydration services, and even more challenging to code”
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Organizations, particularly managers of clinics, health information and compliance, face the challenge of managing their charging practices across geographically-dispersed chemotherapy clinics. As a result, they must be confident that methodologies used for calculating chemotherapy infusion services meet Outpatient Prospective Payment System (OPPS) Guidelines, and provide a consistent approach to charging practices across all facilities. C/Point and E/Point are centrally-hosted revenue management solutions that are easy to deploy and use, and share the same proven LYNX charging algorithm used to calculate the maximum allowable Current Procedural Terminology (CPT) code in more than 600 hospitals nationwide.
IV coding rules in general are considered very complex, and have been targeted by RAC auditors due to the frequency of payment errors that can arise from noncompliant procedure coding.