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Drug Administration

Drug Administration. CAH uses Non-Medicare Codes for drug administration Learn the meaning of 1 minute time creep 1 hour 30 minutes v. 1 hour 31 minutes Chart start and stop times accurately Hydrate, therapeutic, hydrate Stop when drug stops, even if IV line is kept open

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Drug Administration

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  1. Drug Administration • CAH uses Non-Medicare Codes for drug administration • Learn the meaning of 1 minute time creep • 1 hour 30 minutes v. 1 hour 31 minutes • Chart start and stop times accurately • Hydrate, therapeutic, hydrate • Stop when drug stops, even if IV line is kept open • One initial for hydrate and one initial for therapeutic (Transmittal 902)

  2. Blood Administration • One half of blood administration is billed erroneously. • Blood charges • Administration charge • Related lab tests • Cross match • Typing

  3. LOCM • Low osmolar contrast material may be billed separately in a Critical Access Hospital. • Appropriate revenue (636) and HCPCS codes must be used.

  4. Clinical Diagnostic Lab Tests • PPS hospitals are paid for lab services using the Medicare lab fee schedule. • CAHs payment for clinical diagnostic lab tests are made on a reasonable cost basis. • Patient must be an outpatient of CAH • Patient must be physically present in CAH when specimen is collected. • Tests for non-patients of the CAH (RHC, HHA) are paid under the Medicare lab fee schedule.

  5. Ambulance • Critical Access Hospital may receive reasonable costs for ambulance services. • Must be furnished by a CAH or entity owned and operated by CAH • CAH or entity must be the only provider of ambulance service with 35 miles

  6. ABN • Advance beneficiary notices are used to • Inform Medicare beneficiary BEFORE receiving service that Medicare may not pay • Allow beneficiary to make informed decision whether or not to receive service he/she may have to pay out of pocket.

  7. CSW • Medicare may pay for clinical social worker services in an outpatient setting. • If furnished under partial hospitalization program, payment is included in PHP rate. • Other CSW services may be billed to carrier on Form 1500. • CSW payment will be at 75% of fee schedule for PPS hospital. • CSW payment will be a reasonable costs for CAHs. • Part B deductible and coinsurance applies

  8. Private Room Differential • May negatively impact CAH rates • Medicare will generally only pay the costs of semi-private rooms. • If there is a differential in charges between private and semi-private room, this charge differential will be used to reduce the costs associated with a semi-private room. • Private room differentials could also negatively impact ICTF program payments.

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