Tetralogy of Fallot
Tetralogy of Fallot (TOF), often called "Blue Baby Syndrome", is a congenital defect involving 4 distinct defects: pulmonary stenosis, ventricular septal defect, right venticular hypertrophy, and an overriding aorta. Surgical intervention is critical in correcting all 4 defects. Surgery may also be planned in stages as the baby continues to grow.
LOS ANGELES, CA 90027
The Bundled Rate plus Outlier Per Diems includes:
1. Those comprehensive facility services, supplies, and equipment necessary to perform the Bundled Procedure and rendered by Hospital or ASC. 2. Those professional services necessary to perform the Bundled Procedure and rendered by a Physician. 3. The treatment of any complication or concurrent illness associated with or resulting from the performance of the Bundled Procedure during the Bundled Rate Payment Period. 4. The ECMO per diem, which is $32,250, is payable for members who are in need of ECMO assistance during and after the surgical event. The ECMO per diem includes: initiation and maintenance of equipment, labs every 6 hours, 24-hour coverage, blood transfusions & gases. The Bundled Rate Period covers the 1 day(s) prior to the procedure for the scheduled Accarent Procedure and up to 5 inpatient days in the hospital. Should the length of stay exceed 5 inpatient days, then per diem outlier payments will be applicable for each subsequent inpatient day. Covered outpatient follow-up services related to the bundled procedure beginning on the day of discharge through 30 calendar days are included in the bundled price.
Patients born at 37 weeks or less. Any genetic abnormalities (ie: chromosomal abnormalities- deletion/duplication, 22q11 deletion, trisomy 13, 18, and 21, 45XO). Syndromes (ie: DiGeorge syndrome, Down syndrome, Turner syndrome, Williams syndrome). Non-Cardiac Congenital abnormalities (ie: hydrocephalus, tracheoesophageal fistula (TEF), congenital diaphragmatic hernia (CDH), imperforate anus, hypoplastic lung).
Candidacy for the bundled procedure will be determined by the Provider.