Never Event Billing

[HSUMNER18]

Hello, I work for a plastic surgery group. One of the surgeons has asked if they can bill for a patient that was referred to us for an ulcer that was received during an extended inpatient stay at the hospital. We have been told ulcers are "Never Events" but I feel like that is more for the hospital and we should still be able to bill for it as with any ulcer patient.

[Michele]

I'm not sure I understand what you are asking.  Did the surgeon see the patient as an office visit?  Did they do surgery?  If the surgeon saw the patient and did surgery it should be billed.  Even if the ulcer was caused due to an error in medical care the patient needs it to be treated. 

[PMRNC]

What is the procedure? The patient might have a plan that specifically includes certain procedures which is a "never event" Suggest if this is a group health plan asking patient for their SPD and get them to help with obtaining authorization.