Transplant Insider

Quarterly Publication by Guidry & East, LLC

In This Issue
Latest News
Leader in Transplant Admin Award Winner
CMS Updates
Quick Links
for stopping by


We enjoyed meeting new people and seeing familiar faces at
UNOS Transplant Management Forum 2016.
We look forward to the  opportunity of collaborating with you again soon!

  Spring 2016

Guidry & East brings you our sixth Transplant Insider, a quarterly publication comprised of resources and news vital to developing your transplant business solutions for growing transplant programs, improving transplant operations, and the transplant financial product line.

We look forward to being your provider of the latest policies and procedures in quality patient care.



Latest News



Revised CMS Interpretative Guidelines On Hold
Representatives from the AST's Transplant Administrators Community of Practice joined President-elect Anil Chandraker and representatives from ASTS on a recent call with Mr. Thomas Hamilton, Director of the Survey and Certification Group at CMS. Both societies shared their concerns regarding revised CMS Interpretive Guidelines for the Organ Transplant Conditions of Participation for Transplant Centers.

Article can be found  hereread original letter here .
CMS - Outcome Threshold Change
Subject: Solid Transplant Programs, Outcome Thresholds, Revised Guidelines

Article can be found  here.
Chapter 31:
Organ Donation and Transplant Reimbursement

The Medicare program has established policies which support organ transplantation by providing an equitable means of payment for the variety of organ acquisition services required to support quality transplant programs. The following instructions explain how Medicare reimburses for organ acquisition costs of covered transplants provided to Medicare beneficiaries.

Article can be found  here.
2016 Deedle Heckenkemper Leader in
Transplant Administration Award Winner

Betty Crandall, MS, RN
of Wake Forest Baptist Medical Center-Winston-Salem, NC

We at Guidry & East are so proud to announce Betty Crandall, MS, RN, as the winner of the 2016 Deedle Heckenkemper Leader in Transplant Administration Award. In honor of Ms. Crandall's dedication and diligence in transplant administration, we bestow our greatest award.

As the leading authority in transplant, Deedle Heckenkemper helped pioneer the specialty of transplant administration. His career spanned 40 years and he was the co-founder of the Organ Procurement and Transplantation Network / United Network for Organ Sharing (OPTN/UNOS) Transplant Administrator's Committee. Deedle died unexpectedly in 2011. The award is named in recognition of his pioneering efforts in the field of Transplant Administration. 
Liver Distribution Policy Proposal to Advance for August Public Comment
Rosemont, Ill. - The OPTN/UNOS Liver and Intestinal Organ Transplantation Committee  , at its meeting April 27, agreed on a proposal to be shared with the public for input in order to improve liver distribution nationwide. The proposal, to be published for public comment in August 2016, is intended to increase consistency in medical urgency scores at transplant for candidates in various areas of the country.

Article can be found  here.
New Data Services Section on UNet Now Includes Center STAR files
The Thoracic Committee is proposing modifications to the adult heart allocation system and these proposed changes are currently out for public comment.  The Committee presented a webinar on February 2, from 2-3:30 p.m. (ET), to explain the proposed changes, and to encourage members to comment on the proposal.

Article can be found  here.
Update Your Internet Browser to be Ready for UNet System Upgrade
Coming in September/October 2016, UNOS will complete enhancements to the Secure Enterprise system, that will enable all users to access UNet and other transplant applications (e.g. Waitlist, DonorNet, KPD, TIEDI) with Internet Explorer 11 (IE11) or Google Chrome web browsers. Make sure you have one of these browsers available at time of implementation.

Article can be found  here.
Call for 2017 TMF Abstracts
The UNOS Transplant Management Forum is accepting abstract submissions for the 2017 forum, scheduled for April 25-27 at the Loews Sapphire Falls Resort in Orlando. Members of the Transplant Administrators Committee will review your submission and consider it for a plenary session, concurrent session, 15-minute oral presentation, or poster presentation and award.

Article can be found  here.
Watch for 2016 UNOS Member Survey in Late May
Each year UNOS surveys more than 7,000 transplant professionals representing transplant centers, labs, and OPOs. We use this valuable feedback to help us identify new projects and needs as well as improve and prioritize existing services.

Article can be found  here.
Pediatric Heart Allocation Policy and System Changes
In June 2014, the OPTN/UNOS Board of Directors approved changes to improve survival for pediatric heart transplant candidates.

Read  here.
OPTN/UNOS Officers and Board Members Elected
Richmond, Va. - Members of the national organ donation and transplantation community have elected 26 members to the OPTN/UNOS board of directors, including a new president, vice-president/president-elect, vice president for patient and donor affairs, and secretary. United Network for Organ Sharing (UNOS) serves as the Organ Procurement and Transplantation Network (OPTN) under federal contract.

Article can be found  here.
New Qualified Health Care Professional Requirement as Part of ABO Policy Changes
Qualified health care professional is a new term used in the ABO policy changes that will go into effect after June 1, 2016. Upon implementation, policy will define a qualified health care professional as a person who is qualified to perform blood type reporting or verification requirements as defined in the OPO, transplant hospital or recovery hospital written protocol.

Article can be found  here.

CMS Updates

from the 
Department of Health and Human Services
Centers for Medicare & Medicaid Services:

Updates to Medicare's Organ Acquisition and Donation Payment Policy
Article intended to assist providers and suppliers by offering information and resources to clarify Medicare's organ acquisition and donation payment policy for organ procurement, transplant, and histocompatibility laboratory services provided to Medicare beneficiaries.

Article can be found  here.
Interpretive Guidelines for the Organ Transplant Conditions of Participation (CoPs)

Revised May 3, 2016
Organ Transplant Interpretive Guidelines Update: The attached Interpretive Guidelines for the Transplant CoPs at 42 CFR ยงยง 482.68 through 482.104 are temporarily ON HOLD pending additional revisions, clarifications and corrections.

Article can be found  here.

Q & A
brought to you by UNOS


Answers to Common Questions About
Data Submission

UNOS routinely receives questions from member institutions about data that is required. UNOS collected common questions received and provided answers below.

Question: How do you define an admission? Does admitting a recipient (or living donor) for observation count? Or do they need to be an inpatient or have a stay longer than 24 hours?
We define an admission as any admission that is reimbursable under current CMS regulation.

Question: How do I report transplant dates for a multi-organ transplant procedure?
When you remove a waiting list registration, the transplant date you report should be the first anastomosis date of the organ(s) associated with that registration. For example, if you remove a kidney/pancreas registration from the waiting list, you can only report one transplant date (anastomosis date of whichever organ was first anastomosed). If  your recipient receives a kidney and a liver, you should report  the kidney transplant date as the anastomosis date of the kidney, and report the liver transplant date as the anastomosis date of the liver.  

Question: Do I report a patient's death on the TRR form if he or she died soon after the transplant date?
Yes, you should report the death of any patient that dies before they are discharged on the TRR. 
  • The TRR form should have a patient status date, status and information on the patient at the time of hospital discharge or six weeks after transplant, whichever comes first.
  • If a patient dies more than six weeks after transplant, you should not report the death on the TRR but rather on the 6 MO form, if it has generated. If a 6 MO form has not been generated, report the death on an Interim Event death form.
Question: When do I create an Interim Event death form?
If there is already an expected form for the patient, complete and validate the form with the death information. Once you validate the form, it will become an RD - Recipient Death form. Unless there is a lost form or other form that needs to be removed, you do not need to open a Service Portal request to notify us of the patient's death. If there is no expected form and you need to report a patient's death in Tiedi, you would use the Report Interim Event link from the patient history page.

Question: I need to complete my TRF form and have no data to submit. I am trying to decide if I should report the recipient as "Lost to Follow-up" or "Not Seen." Is one option better than the other?
You may submit a request through the UNOS Service Portal to make the patient status "not seen" on a TRF. Reporting the patient as "not seen" for this year allows next year's follow up-form to generate on schedule, in case data become available then. If you report your patient as "lost-to-follow up," no future follow-up forms will be generated.
Example: If the transplant was performed on January 1, 2010 and you have no follow-up data to report on the six year follow-up form, you may submit a request to report the patient status as "not seen." We will use the anniversary date of the form (January 1, 2016) as the patient status date.
Note: Data Quality no longer requires you to report a patient status as "lost to follow up" if you have reported "not seen" on three consecutive TRFs. You may now report "not seen" for more than three consecutive TRFs to accurately reflect your interaction with the recipient.

Question: Status Fields exist for some data elements and enable you to indicate a value of "Missing" or "Unknown" or "Not done" in lieu of entering an actual value. What is the definition of Missing, Unknown, and Not done?
Missing - you do not have the data and cannot get it
Unknown - you do not know if the data exist, and there is no way for you to verify that it does or does not exist. An example of when this might be used would be if the historian for a patient was not aware of a particular element of a patient's social history and there was no way to get that information.
Not done - you did not perform the test. For a specific example, on the thoracic TRR we collect hemodynamics before the transplant. If you did not perform any invasive hemodynamic measurements at any point before the transplant (even during the evaluation phase), then you could select 'Not done.'

Common data submission questions and answers can be found here

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