Context
What happens to billing of a private patient in a public hospital who undergoes solid organ (other than kidney) transplantation? There is no MBS item billable for this so it can’t be billed to the patient’s private insurance, so can the hospital just change them back to public or does the patient have to be involved in that decision? Follow-up question asked. This updated context was provided. I think the situation is a bit more complex because it is not correct that patients are aware at the time of admission that they require a solid organ transplant, unless they are admitted to hospital from a transplant waiting list. A significant proportion of liver, heart, lung transplant patients are admitted to hospital with an infection, poisoning or trauma, that eventually leads to irrecoverable organ failure and a requirement for transplantation – sometimes months into the admission. If we follow the logic in your answer, anyone who has any chance of developing end stage organ failure that could be then eligible for a transplant should be admitted by default as public, which would be counterintuitive. So to be more specific, the question would be this: How should a hospital and clinicians approach a situation when a patient admitted with an acute condition (NOT previously on a transplant list) develops end stage organ failure and requires liver, heart, lung, etc transplantation during the course of their hospital admission (a good example would be a community acquired pneumonia or chest trauma leading into complicated...
