HH & Lab billing

What a wonderful addition to your office. I would love to have one of these in ours! Saves a lot of time dropping off at hospital plus you can get the results faster. I don't know the specifics of what you are asking, but it seems logical that it should be billed seperately. If you took the blood to the lab, they would bill and doing bloodwork in the office is not considered part of our services. How it needs to be done, I'm clueless. How about talking to a MD office that does labs inhouse?

The test does need to be included on your waiver paperwork plus you need a competency program to teach its use, a program on how to care for the machine, who is going to calibrate it/quality control check, who is allowed to operate it, and all the records that go along with all the above.

Coming from the educator side, personally I would not want to create the program to do that or keep all the records related to this. Just be prepared you may get someone to show up and check all those records and add that program education to your competency program at the hire date skills checking as well as your defined timeframe for re-compentency.

renerian

I am a new director of a small home health agency. This agency recently obtained a Prothrombin machine and the nurses have been using it for monitoring PT's per MD orders for our coumadin patients. I think this test falls under our CLIA Certificate of Waiver and that we can bill Medicare for the test instead of absorbing it into the PPS payment as they have been to this point.

Anybody have the info?

Thanks in advance for help you can offer.

The agency I worked for also used the Protime machine,the training was treated the same as for our glucometers. Once a year competency checks,the machine does its own self check each time its used,if there are any problems a code number pops up which you document on the supplied log and the supply room clerks would followup with our nurse educator. I know we billed separately for it and were reimbursed but I don't know the specifics.It is very accurate and convenient to use.and if there was any problems you would have vp supplies as a backup.MD's like being able to adjust coumadin immediately,the machines are not cheap(about 5,000 dollars each) so I know we were getting reimbursed for each use as the facility I worked for would not have absorbed the cost and we had six machines and supplies.

I know this post is several years old, but I may have some info that can help you. You can bill for the PT/Inrs separately through your CLIA waiver. However, the reimbursement you will qualify for is an administrative reimbursement-not the technical fee. This reimbursement is for documenting the results of the lab as well as communicating the results to the physician. You can receive this reimbursement for all of your CLIA waived labs. I won't go into much more, as I am new to this site and don't even know if you will be notified that I posted this response. If you are, send me a message and I will fill you in.

Can you please help me with this lab related question. I have a private insurance pt who had recieved an order for labwork from another doctor/specialist, and the pt went ahead and got it done from a lab. Now, can u tell me if the insurance is going to deny payment to the lab and what is the best way to handle a situation when such an order is given by a physician who hasn't signed the POC. Thank you very much in advance.

Hello,

i myself work with a home health care business, I am having this same problem going on here, I was wondering have you found out what it takes to do this billing for clia waived labs?