This is a catch 22 situation.
A. Medicare does not pay for infusion therapy in most instances.
Who is paying for equipment: Huber needle and flush solution???
If patient has secondary insurance in addition to Medicare, they will pick up cost of supplies and often nursing visit, usually they bundle cost SN visit included under secondary and provide via infusion company if your agency does not provide this service. Cost for supplies alone I think is less than $50.000 ----this is the first hurdle to consider.
B. Medicare WILL pay for a nurse to administer IV therapy if patient/caregiver can not be taught (DOCUMENT lack of dexterity, unable reach location etc and homebound status extremely well) if payment for supply issues resolved. This would be a LUPA payment if visit is only monthly port mgmt.
C. What is type of anemia has been diagnosed. Any co-morbidities
Can teaching be done re diagnosis, eval/ instruct nutrition and hydration, calorie count etc, instruct med managment, labs to monitor H/H, B12 level etc., eval compliance with POC..... This could be done on weekly basis first month, then 2x month especially if co-morbidities, pt lives alone or multiple unskilled caregivers, eval risk falls if frail, eval forgetfulness etc. Thus, port flush is secondary to above care activities.
Recert must show PATIENT CHANGES: getting weaker, non-compliance med regimen, or med changes or improvement till goals met. Document homebound status each visit.
D. If patient truly stable and unable bill medicare, get MC form signed for denial, and bill to secondary insurance if pt has one.
See links here: http://allnurses.com/forums/f23/4-06...ted-90744.html