Can I charge for a RedCell LeukoReduced P9016 even though just a Packed RedCell P9021 is ordered?

[AFiddler]

Our blood supplier only sends leukoreduced Packed cells. If we write a reflex policy that informs the doctors that an order for Packed Red Cells will be charged as a Packed Red Cells-Leukoreduced- is that legit?

[Lcsmrz]

We are 100% luekodepleted -- it's the only product that I can get from my blood supplier. The transfusion committee has sanctioned this.

The physician can write anything he wants that's decipherable as a unit of RBC's. He's gonna get a leukodepleted packed cell, and the patient will get charged accordingly ...

[Liz]

You can inform all Medical, House and Nursing Staff through the Chief of Staff or your chairman that all RBC units are leukoreduced. Prior to that, have the administration study this, perform a cost-analysis and come up with one code and one cost for these. I would not get involved in informing doctors, nurses and families of the cost, thats for administratin to do as it will get messy otherwise.

[Lori McClintock]

This has recently been a topic in our area. Some hospitals are 100% leukoreduced, some are just going to that, and some are not. The question was sent to CMS I have attached their response. We sent a memo to our physicians stating that our red cell inventory is 100% leukoreduced and asked them when ordering, to indicate leukoreduced red cells. We are also in the process of going to Physician Order Entry, when the computer prompts them to select a component type we only give them the choice of leukoreduced or leukoreduced/irradiated.

CMS answer on Leukoreduced RBC.pdf

[David Saikin]

We are 100% leukoreduced. Approved by the med staff 12 years ago. When they order rbcs they know they are getting leukos. No problems with remuneration on that front.

[Dr. Pepper]

I'm ditto with David. I think it's essential to get the OK from the med staff or get into your hospital's transfusion policies that all RBC units will be leukoreduced (or standardize your platelet dose, or whatever you ordering ambiguities or pet peeves are....). An electronic or paper order form with a LEUKOREDUCED RBC check-off box as the only packed cell option could help as well.

[Liz]

Exactly, just one option, one code, and one charge, since that is what you offer.

Let the COS or Chair inform all the Medical Staff for you.

[sbrodbeck]

Agree about the Med Exec approach. Coding convention states, report the service provided to the highest level of specificity. Many other scenarios fit in this question. How about a short dated ONeg unit that has been irradiated? Yep, you guessed it, you should report the services provided includding an irradiated unit that may have not been specifically by the phyiscian. Clinically this is important as well as reporting properly for cost accounting and claims preparation. I suggest you create a fairly extensive blood substituion policy, which most of us have it is just not formalized. This is a major step in inventory control.

Sorry to highjack the topic...... :>)