The Doctors Want Me...LPN and Labs

[MYRN2016]

Greetings:

In the last 2 weeks I have had 2 of the physicians that take care of the residents in my facility approach me with an idea that has now sprung into the second phase of my business endeavor.

One would like for me to go to all the assited living facilities where they have patients at and do their blood draws and other specimen collections. This I believe has developed from my constant complaint that some of my residents PT/INRs or Depakote levels are consistently late. We used to have a home health agency come in , but recently the HHAs have been stating that due to medicare guidelines they cannot provide this service on a monthly basis.

Then there is a RN in our area who charges families $75, to come do their labs. But, there have been some issues between her and a few physicians.

I have had to take residents to a local lab and sit sometimes for an hour just so they could get their blood drawn. Some of my residents have severe dementia become agitated.

I think I can do this. But, as an LPN I am unsure of the laws. When I worked for agencies I would do blood draws. I would think because I am getting my orders from the physicians this would be okay.

My questions:

1. What is a reasonable charge for blood draws and straight caths?

2. What type of documentation would be involved?

Thanks,

AmiRah

PS.

REmember all of my business is focused around those who are home bound or who primary caregivers are unable to transport to get labs, pickup medications etc.

[Jo Dirt]

I'd like to know about this, too. Sounds like it could be a good business.

[Wgbem]

I would also like to hear more about this. I do quite a bit of blood draws already so why not do it for my own business.

I would appreciate any info you can provide.

[txspadequeenRN, BSN, RN]

This is a really good idea...Ill wait right here for someone who knows...

[Agnus]

Before you get too excited talk to your board of nursing about this. They are the final athority as to wether you can even do this. You may with some restrictions or you may not beable to do it at all.

[jer_sd]

This could be a good idea. Both phlebotomy and urinary cath have CPT codes so it is a billable service. Since you would only br preforming these tasks after receving a order from a doc there should not be legal issues as long as phlebotomy is within your scope of practice.

But you might run into problems billing insurance for your services. Also will the docs pay you for the service as an independant contractor (they might be able to bill for services I am not sure), or will the patient bill you? I wonder if you would need to be a laboratory facility to bill for this. See if you can contact you medicare or medicaid agency to find out.

Who will supply the equipment?

Let us know what you find out.

[AfloydRN, BSN, RN]

SOunds good. Just make sure you have been certified as a phlebotomist in the state you reside.

[Agnus]

In some states if you are and LPN/LVN (I know because I ran up against this as an LPN who also happened to be a phlebotomist) The BON has the final say about blood draws, even if you are a state certified phlebotomist.

Being a nurse complicates our life in so many ways especially (I found) being an LPN/LVN. So in the state were I was because I was now an LPN and the BON said that LPNs could not draw blood I was not allowed to draw. Even though I was certified by that state as a phlebotomist. Crazy.

I supose if no one knew I was an LPN and never marketed myself as an LPN I might have gotten away with it. Will someone please, bring some sense and consistency to BONs about LPN/LVNs?

Hopefully this is not an issue for you. In anycase check with your BON, they have the final say.

Don't depend on the MD to know. The truth is they know next to nothing about such things. Many docs don't even know they can't call thier MA a Nurse if they choose to. They figure since she is doing nursing type duties for him he can call her anything he wants.