Transplant Services

Transplant services encompass the costs associated with organ and tissue transplantation procedures. These costs include pre-transplant evaluations, surgical procedures, post-transplant care, and associated pharmaceuticals. Given the complexity and variability of transplant services, it's crucial to accurately capture and represent these costs in MRFs for hospitals with transplant centers.

Inclusions and Carve-outs
Specific Codes: Transplant services often have unique billing codes and methodologies that are not necessarily included in standard CDMs. These may include specific codes for organ acquisition, transplant procedures, and post-operative care. The first key step is to identify these services, alongside their negotiated rates, to ensure they are accurately represented in the MRF.

Algorithms: For complex transplant services that involve multiple stages and variable costs, Turquoise includes relevant details in the algorithm field of the MRF. This helps capture the nuances of transplant service pricing and ensures compliance with CMS requirements.

By accurately identifying and including the payable services and relevant details, Turquoise ensures that the MRFs reflect the negotiated rates for transplant services, promoting transparency and aiding in compliance with regulatory standards.