Percutaneous procedure in OR

My question is a little crazy. When we have a patient in the PICU in Observation status and the Nephrologist wants to perform a percutaneous kidney biopsy, 50200 we need to take the patient to the OR because there is not anyone available to provide sedation in the PICU. The OR staff want's a guarantee that they will be paid. Is there some reason that the OR charges would not be paid on a patient in outpatient/observation status?

Thank You
Louise

probably a little late

I have never heard of an OR "Staff" asking for a guarantee of payment. Aren't they paid by the hospital? The anesthesiologist can file his own professional charges for the services rendered. Now if the "hospital" is asking for a guarantee then they should contact the insurer to get pre-certification.

That being said, a kidney biopsy is generally a semi-elective procedure and if the patient is on observation status it is most likely for another reason than to get the get the biopsy performed. Also it is unusual to have an Observation patient in an ICU- ICU's are usually for sick patients and Observation is to determine if a patient is sick enough to be in the hospital at all. And while it is convenient for the physician to do elective things while a patient is in the hospital, it hurts the hospital financially since they are usually paid per day or per admission, no matter what is done. So if they did elective kidney biopsies in every kid in the hospital for asthma then the OR costs, path fees, longer LOS, risk of complication would eat up any potential profits. We in case management call this the "While you are here" phenomenon.

Make sense?