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Can RN do emergency Pump refill in ofc?

  1. Exclamation Can RN do emergency Pump refill in ofc?
    Medical Coding Books
    Hi All...

    I have a WC patient who missed her pump refill appt, now she is in emergency mode as her pump may dry up...we have no supervising Physician or CNP on site today, only an RN...can she fill the pump? How do you bill emergency services such as this to an MCO? Or would this not constitute an emergency, and the pt would be responsible for pmt, IF it is all possible to do...

    We have never been faced with this scenario before. We thought about referring her to an emergency room, but they do not do pump refills...

    Any information would be greatly appreciated..

  2. #2
    You have a problem. RN's can't be credentialed (I don't think so, anyway), so you can't bill using their name. That means you have to bill "incident-to" a physician service. But you can't do that either since there was none on hand to supervise. Furthermore I'd be surprised if any insurance would consider an empty pain pump as an "emergency". Inconvenient to be sure, but not life-threatening to the patient.

  3. #3
    Columbia, MO
    I agree. RNs cannot provide service to a patient without the supervision of a physician. The exception are of course home health nurses but they follow different criteria and bill differently.

    Debra A. Mitchell, MSPH, CPC-H

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