Expert,I have a med A resident with a NEW gtube placement, but was done in Barbados. He is 90 y/o, vacationing in his country, had CVA and needs gtube. Came back to US and used Med A in our facility. Is it ok to skill for gtube even if it was not performed here in US? Thank you!
MunoRN, RN 8,058 Posts Specializes in Critical Care. Has 10 years experience. Oct 28, 2017 I'm not sure why you think it wouldn't qualify for medicare or Medicaid coverage?
Talino 1,010 Posts Specializes in ER CCU MICU SICU LTC/SNF. Oct 29, 2017 Expert,I have a med A resident with a NEW gtube placement, but was done in Barbados. He is 90 y/o, vacationing in his country, had CVA and needs gtube. Came back to US and used Med A in our facility. Is it ok to skill for gtube even if it was not performed here in US? Thank you!A reasonable concern. CMS, however, states ...20.1.1 - Three-Day Prior Hospitalization - Foreign Hospital(Rev. 228, Issued: 10-13-16, Effective: 10-18-16, Implementation: 10-18-16)A stay of 3 or more days in a hospital outside the United States may satisfy the prior inpatient stay requirement for post-hospital extended care services within the United States if the foreign hospital is qualified as an "emergency hospital" (see Pub 100-04, Medicare Claims Processing Manual, chapter 32, §§350ff. for a description of foreign and emergency services payable by Medicare. Read the additional guideline pp 10-11 https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/bp102c08.pdf
