School Nurse Procedure Manual - The School District of Philadelphia

SCHOOL DISTRICT OF PHILADELPHIASCHOOL NURSE PROCEDURE MANUALSUBJECT: MISCELLANEOUS NUMBER 809.0CLASSIFICATION:ACCESS BILLING PROCEDURE (SEP. 02)I. INTRODUCTION:The School District of Philadelphia may bill Medical Assistance (MA) through theACCESS program for certain services which are medically necessary. Thesebillable services include many of the services being performed by school nursessuch as: Administration of prescribed medications, tube feedings and urinarycatheterizations.II.CRITERIA FOR ELIGIBILITY:A. The student has Medical Assistance.B. The student has been classified as Special Education, Chapter 14.C. The parents have been notified of the School District’s intent to bill MA and a datedcopy of the letter has been placed into the student's file.D. A medical diagnosis and physician's certification of need are on file. The Requestfor Administration of Medication/Equipment, MED-1), meets this criteria.E. The student must be receiving a service that is specified on the MED1 (daily,weekly, 3 x week). PRN services are billable when the MED1 covering the serviceis on file, i.e. nebulizer treatment.***F. The service must be listed on the student’s Individual Education Plan (IEP). Thefollowing phrasing is to be used to include nursing services on the IEP:"ADMINISTRATION OF MEDICATION/TREATMENT PERPHYSICIAN'S ORDERS, AS PROVIDED BY PARENT AND INCOMPLIANCE WITH SCHOOL DISTRICT POLICY"III. PROCEDURE:The Certified School Nurse will:A. Obtain and review documentation of medical necessity, diagnosis, and physiciansignature on the Request for Administration of Medication/Equipment (MED-1) inall cases.B. Ascertain that the following statement is on the IEP: “Medication/treatment perphysician's orders, as provided by the parent and in compliance with SchoolDistrict Policy.” If it is not listed, the nurse should meet with the IEP Chair/LEArepresentative at the school and make arrangements to have the service added in amanner that maintains the integrity of the IEP.C. Document administration of medication/treatment on computer medication log or,when unavailable, on “Student’s Record of Medication Administered or EquipmentUsed” (MED-2).D. Prepare Service Description Slips at the end of each month for those students thathave been identified as Chapter 14 Access Eligible and submit them to the MedicalAssistance Reimbursement Coordinator for their AAO. The nurse may only bill forthose dates when he/she is in the building providing (or overseeing) the service andthe student is available . Services may not be billed for dates when themedication/treatment is provided by another individual because the nurse is not inthe building..E. Complete all relevant columns on Service Description Slip including: Diagnosis,Date, Therapy or/Evaluation or Collateral, Progress Indicator and Service Time andSeptember 1, 2002 Page 170