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vascular access catheter infections

CMS never events indicate that vascular access catheter infections are not reimbursed.  I think there seems to be some confusion and maybe we need a clear and concise answer.  All catheter infections are no longer reimbursed if they are hospital acquired including peripheral IV's, midlines, central lines of any kind and I assume arterial catheter infections.  Medical records codes these infections and that data is transmitted to CMS and reimbursement is not allocated.  All vascular access infections are subject to non-reimbursement at this point.  As far as reporting goes at this point CMS is only dictating the reporting of central venous catheter infections to the CDC NHSN database for ICU patients at this time.  This is not to be confused with reimbursement.  Reporting and reimbursement are different topics.  in some states infections are reported at as state level to a database and those may include all vascular access devices or just central lines.  At this point as far as CMS is concerned the reportable rates are ICU however the non reimbursed infections include all vascular access catheter infections which is not isolated to a central line.  If I am unclear of this definition please enlighten me.

Kathy Kokotis RN BS MBA

Bard Access Systems

ann zonderman
  Currently 28 states have

  Currently 28 states have mandatory reporting regarding HAI. This includes CRBSI  some are looking only at ICU, California is now collecting data for other units.  Many state funded programs are followoing CMS guidelines (Medicaid programs).  But   It is not all about reimbursement, but about improving patient outcomes


  FYI - This topic will be a presentation at AVA in October...

Ann Zonderman, BSN, JD, CRNI

First of all, CMS does not

First of all, CMS does not refer to their list as "never events". Their list contains 10 hospital-acquired conditions. You are correct that CDC language is quite different from CMS language. CDC/NHSN only collects data on CLABSI - central lines only and only blood stream infections. They are quite specific in their definitions. The original NNIS data from CDC only collect critical care patient data, but now the NHSN is open to all areas of the hospital and all types of facilities. Many states requiring public reporting of infections will report according to the CDC definitions. CMS language does not allow the hospital to add modifiers to the DRG to increase their payment for treating these identified conditions. CMS language is "vascular device associated infections", which would include all types of catheters and all types of infections. So cellulitis from a short peripheral catheter would be included as well as supprative thrombophlebitis. So there could be lots of infections going unreported when a facility follows CDC, but they are still not getting paid for treatment from CMS. I raised this problem to a CMS person in a conference a few days ago. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Lynn thank you for agreeing

No vascular access catheter infection that is acquired in a healthcare facility such as a hospital is reimbursed.  So those who go to midlines and PIV's to avoid reporting are losing money but currently they do not have to report those infections.  We will see this change is my guess as CMS is now collecting data on all VAD's for non reimbursement.


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