OAR 410-148-0040: Requirements for Home Enteral/Parenteral Nutrition and IV Services

(1) Home Enteral/Parenteral Nutrition and IV Services: (a) Home enteral/parenteral nutrition and IV services must include training and/or education of client or support person on nutritional supplement and /or equipment operation; (b) When enteral/parenteral nutrition and IV services are initiated in a hospital setting, reimbursement for training is included in the hospital reimbursement and will not be made separately; (c) Reimbursement for enteral/parenteral and IV services training when done in the home is included in the payment for the nursing visit(s); (d) Per diem reimbursement includes: administrative service, pharmacy professional and cognitive services, including drug admixture, patient assessment, clinical monitoring, and care coordination, and all necessary infusion related supplies and equipment. Enteral/parenteral formula, drugs and nursing visits are not included in per diem rates and must be billed separately. (2) Home enteral nutrition: (a) Home enteral nutrition is considered medically appropriate to maintain body mass and prevent nutritional depletion, which occurs with some illnesses or pathological conditions; (b) Home enteral therapy may be administered orally or by enteral tube feeding, i.e., nasogastric, jejunostomy or gastrostomy delivery systems. (3) Home parenteral nutrition: (a) Is considered medically appropriate for treatment of gastrointestinal dysfunction such as severe short bowel syndrome, chronic radiation enteritis, severe Crohn’s disease, or other conditions where adequate nutrition by the oral and enteral routes is not possible: (b) Initiation of home parenteral nutrition services must include client or support person education on catheter care, infusion technique, solution preparation, sterilization technique, and equipment operation; (c) Parenteral nutrition is appropriate only when oral or enteral feeding is inadequate or contraindicated. (4) Home intravenous (IV) services: (a) Home intravenous (IV) services are covered by the Division for the administration of antibiotics, analgesics, chemotherapy, hydrational fluids or other intravenous medications in a client’s residence, (i.e., home or nursing facility) or an Ambulatory Infusion Suite (AIS). (b) In addition, the provision of all goods and services needed for maintaining venous or arterial access and required monitoring is covered.