Procrit

[BabaLouRN]

I have been taught that routine Lab draws every 3 weeks and then PROCRIRT injections given in the home according to the result of the labs.

I believe Medicare does not consider this as a skilled need and I have never heard of PROCRIT being given in the home. Any thoughts?

[Libby1987]

We do it if already providing other skilled services but not as a stand alone skilled service. Lab draws aren't skilled and we don't keep patients on service for essentially a prn injection.

[BabaLouRN]

Same thoughts exactly. This is such a difficult thing for caregivers to understand. I understand that a SKILLED NEED is something "only a nurse or therapist can do" So, who draws the blood???

[Libby1987]

If the patient otherwise qualifies for home health with a medically necessary skilled need plus HB etc then we have an SN do the draw. If the patient otherwise doesn't qualify then they're not taken or kept on service and must go to an out patient lab. (We don't have a phlebotomy service in our area.

[KelRN215, BSN, RN]

I had many patients in my three years in home health who were on service for subq injections or got visits for just subq injections. All children, none Medicare. The rules are different.

[Libby1987]

I think the rules are the same but we won't keep a patient on service for PRN injections because unless 5 billable visits or more are made in a cert period, the payment may only be $0-600 to cover all expenses made to provide the service, which of course it doesn't come close.

[danarooo, BSN, RN]

I think the rules are the same but we won't keep a patient on service for PRN injections because unless 5 billable visits or more are made in a cert period, the payment may only be $0-600 to cover all expenses made to provide the service, which of course it doesn't come close.

The rules are different, KelRN215 said all Pediatrics NO Medicare. It's Medicare that says injections/labs are not a skilled service but Pediatric patients aren't on Medicare (LOL)!!

[KelRN215, BSN, RN]

I think the rules are the same but we won't keep a patient on service for PRN injections because unless 5 billable visits or more are made in a cert period, the payment may only be $0-600 to cover all expenses made to provide the service, which of course it doesn't come close.

Medicare is the only payer that pays a flat fee for the cert period though. Every other payer pays for the visits that are done. And the supplies are provided by a supply company, not the agency, that insurance also pays for. I've never had someone on service just for PRN procrit injections but have had kids who get visits for just neulasta, neupogen or methotrexate subq injections.

[Libby1987]

Oops I misunderstood what KelRN215 meant, poor comprehension!