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surgery date vs. transplant date

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Hello all-

We are having a problem here with “surgery date”

vs “transplant date” for billing purposes on our transplants.

Some of our patients come to the OR in the middle of the

night and the transplant takes place, based on UNOS guidelines of anastamosis,

on one day while the OR date is the prior day.

Per our compliance department, we are to use the OR date as

the transplant date for billing purposes. However, our transplant team

uses the anastamosis as the transplant date. We have been having issues

with some of our health plans as they are aware of the actual “transplant”

date and then get the bill with another date. We, then, have to explain

the difference and that “all surgeries” use the OR date as the

surgical date…..Compliance has deemed this to be HIPPA compliant and that

we need to follow this for our transplants as well.

In doing so, we have run into issues of case rates starting

the day prior to transplant…which is then interpreted differently based

on “billing” vs. “transplant”. Our billing office

wants us to draft a generic letter that can go out with claims; however, even

explaining this still begs the question…

Is anyone else having this problem, and have you had any way

of reconciling the problem?

Debbie Mast

Supervisor, Senior Transplant Financial Coordinator

Member, TFCA

Heart Failure, Heart, Lung, Heart/Lung, Liver, Kidney,

Pancreas, Intestinal Transplant Programs

Phone: Fax:

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