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katie CRNI
CMS no longer paying for out-pt dressing changes

I work for a corporation with several out-patient infusion clinics. We have recently been told by CMS that they will no longer pay for dressing changes and IV flushing as it is a function that can be done by the patient and or family. Has anyone else recieved this feedback and how are you responding? I am concerned if pt's and families do the dressing changes then we will see an increase in infection rates. Any feedback would be appreciated--thank you.   Katie

Reimbursement for CVC

Reimbursement for CVC dressing changes and flushes has been an issue for years.  If a patient has a CVC that is being used for scheduled medication in a MD office or in patient (ex. chemotherapy) and needs routine maintenance of that catheter between there is no coverage for the supplies or the flushes and patients without private insurance usually must private pay.  That cost can vary greatly between infusion companies-I have heard of some companies charging as much as $300.00 per month which in my opinion is ridiculous.  We have been teaching patients and families to change their own dressings and take care of their central lines for years with great results.  If patients are taught correctly and it's stressed to them the importance of sterile technique they may do a much better job that some clinicians since that line may truly be their "life line".  Long term TPN patients are almost always taught to be self-sufficient with their therapy and can go years without any issues.  The key is to make sure they are taught correctly and stress to them the importance of maintaining good technique whether it be just daily flushing or weekly inj. cap/dressing changes.


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