Pacjent na oddziale intensywnej terapii z zabiegami poza oddziałem. Jak to rozliczyć? Email
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SłabyŚwietny 
Wpisany przez Marek Wesołowski   
Poniedziałek, 14 Sierpień 2017 12:11

Opis sytuacji

Pacjent leży na OIT, ale musi mieć wykonany zabieg poza tym oddziałem. Po tym zabiegu wraca na OIT.

To się zdarza np. po operacji ostrej trzustki, gdy robi się płukanie lub np. gdy pacjent ma zagrażający zawał i na kardiologii ma wykonaną koronarografię i wszczepienie stentów. Realnie pacjent jest poza OIT przez 2-3 godziny.

Jak to rozliczyć?

Szpital ma dwa wyjścia

  • pacjent pozostaje na OIT i tylko podwyższamy TISS o 5 punktów za zabieg poza OIT,
  • pacjent jest przenoszony na oddział, na którym ma wykonaną procedurę i wtedy ten oddział może próbować rozliczyć grupę JGP - np. OZW, bo wszczepił stenty.

Problem

Przeniesienie pacjenta z OIT na oddział na czas zabiegu i ponowne przyjęcie na OIT dzieje się tego samego dnia.

Czy można w takim razie rozliczyć i grupę JGP i TISSy? Będziemy mieli grupę JGP w ramach jednodniowego pobytu na oddziale, na którym wykonano zabieg i dla tego samego dnia zażądamy od NFZ pieniędzy za punkty TISS.

Tak można zrobić. Proszę pamiętać, że TISS to świadczenia z katalogu produktów do sumowania.

Oczywiście przeniesienie z OIT na oddział dla wykonania procedury i ponowne przyjęcie na OIT powoduje, że nie można wtedy wyliczając TISS doliczyć 5 punktów za zabieg poza OIT, bo w czasie wykonywania zabiegu pacjent nie był pacjentem OIT.

Czy w takim razie zawsze warto przenosić z OIT na oddział i z powrotem?

To zależy do sytuacji.

  • Jeśli zabieg na innym oddziale pozwala na wyznaczenie grupy JGP, to pacjenta przenosimy, bo grupa JGP będzie bardziej opłacalna od 5 punktów TISS za zabieg poza OIT. Ważne jest to, że przenosząc pacjenta na kilka godzin poza OIT, nie tracimy prawa rozliczenia punktów TISS za ten dzień.
  • Jeśli jednak wykonany zabieg nie pozwala na wyznaczenie grupy JGP, to nie przenosimy pacjenta. Dzięki temu nie mamy pracy papierkowej związanej z przeniesieniem i dodatkowo zyskujemy 5 punktów TISS.
 

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