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Criteria for Inpatient Daily Care Level 6 - Post Transplant Patients (9.11)

Criteria for Inpatient Daily Care Level 6 - Post Transplant Patients (9.11) - Policies, Administrative, UWHC, Department Specific, Nursing Administrative, Patient Charges

9.11

POLICY & PROCEDURE





Effective Date:
November 1, 2012
Revised: 2/29/2016

Administrative Manual
 Nursing Manual
 Other _______________

Policy #:
9.11

Original
Revision

Page 1
Of 3

Title: Criteria for Inpatient Daily Care Level
6 – Post Transplant Patients



I. PURPOSE
A. Patients will be charged a higher daily care rate when they are admitted to selected
inpatient units and meet certain criteria as specified in the Policy section below.
II. POLICY
A. This Daily Care level 6 charge applies primarily to the following units: Heart & Vascular
Progressive Care (93540), Cardiothoracic Surgery (93570), Cardiology (93580), Cardiac
ICU (93590),Acute Medical and Progressive Care (93520), Pediatric Intensive Care
(93400), Pediatric General Care (93410), Pediatric Hem/Onc/BMT/Neuro/Plastics
(93480), and Pediatric Universal Care (93910). Transplant (9365)
B. To receive this charge, the patient must meet both criteria listed below.
1. Admitting service is one of the following: CHF (Congestive Heart Failure), APS
(Advance Pulmonary Service)(Pulmonary), TTX (Thoracic Transplant), CTX
(Cardiac Transplant), PDP (Pediatric Pulmonary), PDR (Pediatric Nephrology),
PDT (Pediatric Gastroenterology), PHS (Pediatric Hospitalist Service), PHR
(Pediatric Hospitalist Service Red), PHW (Pediatric Hospitalist White), PHB
(Pediatric Hospitalist Service Blue) or SGC (General Surgery Children’s Unit);
AND
2. The fact that the patient status is post-transplant must be stated in either the
physician problem list or the physician admission note or the admitting diagnosis.
III. PROCEDURE
A. Upon Admission:
1. If patient meets the criteria section listed above then they should receive an
Inpatient Daily Care Level 6 – Transplant charge until such time as the charge
criteria is no longer met. The admitting nurse will communicate to the Health
Unit Coordinator (HUC) or Patient Care Technician (PCT) the need to implement
the Level 6 daily care charge. The HUC will enter the Level 6 accommodation
code into the Electronic Medical Record (EMR) in order to change the daily care
charge. The correct accommodation code must be entered into the EMR system
before midnight on the day of admission in order for the patient to receive the
charge applicable to the first day of the stay.
2. The admitting nurse on every shift is responsible for evaluating if any new patient
requires the Level 6 charge and for communicating this information to the
HUC/PCT for entry into the EMR.
3. It is the responsibility of each Nurse Manager (NM) to specify which staff

POLICY & PROCEDURE





Effective Date:
November 1, 2012
Revised: 2/29/2016

Administrative Manual
 Nursing Manual
 Other _______________

Policy #:
9.11

Original
Revision

Page 2
Of 3

Title: Criteria for Inpatient Daily Care Level
6 – Post Transplant Patients



member is accountable for charge entry when a HUC/PCT is not working.
Generally, the task of assuring correct charges are reflected in the system will be
assigned to either the Care Team Leader (CTL) or the admitting nurse when a
HUC/PCT is not available. The assigned staff member is responsible for entering
the Level 6 accommodation code into the EMR
4. The defining criteria for a level 6 transplant charge will be available 24/7 on
uConnect for use by staff.
B. Days following admission date:
1. The Level 6 Transplant charge will remain in effect throughout the patient stay.
2. On a daily basis, the NM or Manager’s delegate (e.g. CTL/ Senior Team Member
(STM) or HUC/PCT) is responsible for reviewing all active charges before
midnight and for assuring that all patient charges are correct for the midnight
charge capture. Data pertinent to the daily care patient charges can be found in
either the home page patient list or the unit census snapshot report in Health Link.
3. It is the responsibility of each NM to specify which staff member is accountable
for charge entry when a HUC/PCT is not working. Generally, the task of assuring
correct charges are reflected in the system will be assigned to either the Care
Team Leader or the admitting nurse when a HUC/PCT is not available. The
assigned staff member is responsible for entering the Level 6 accommodation
code into Health Link
C. Daily Patient Charge Review:
1. On a daily basis, the NM or Manager’s delegate (e.g. CTL/STM or HUC/PCT) is
responsible for reviewing all active charges before midnight and for assuring that
all patient charges are correct for the midnight charge capture. Data pertinent to
the daily care patient charges can be found in either the home page patient list or
the unit census snapshot report in the EMR.
2. On a daily basis, the NM or Manager’s delegate (e.g. CTL/STM or HUC/PCT)
must review the Revenue and Usage Report which lists all charges posted for a
patient the previous midnight. A comparison of the Revenue and Usage Report
with the unit census snapshot run for the previous 24 hours will be conducted.
Any patient charge errors discovered as a result of this review will be corrected
immediately. If the patient is not yet discharged, corrections can be made in the
EMR by the unit staff. If the patient has been discharged by the time the error is
discovered, the unit staff will notify the Admissions Department. Admissions will

POLICY & PROCEDURE





Effective Date:
November 1, 2012
Revised: 2/29/2016

Administrative Manual
 Nursing Manual
 Other _______________

Policy #:
9.11

Original
Revision

Page 3
Of 3

Title: Criteria for Inpatient Daily Care Level
6 – Post Transplant Patients



then correct the charge error when feasible to do so.

IV. AUTHORED BY
A. Becky Moore, Financial Officer for Nursing & Patient Care Services


V. REVIEWED BY
A. Amy Armstrong, Manager, Charge Capture, November 2015
B. Andrew Walbrun, Nurse Manager, Cardiothoracic Surgery, November 2015
C. Fran Schultz, Nursing Informatics, November 2015
D. Nursing Administrative Policy & Procedure Committee, November 2015


SIGNED BY:
Beth Houlahan, DNP, RN, CENP
Senior Vice President Patient Care Services,
Chief Nursing Officer