Home Health & Hospice Week

Don’t forget specific dates.

It’s increasingly likely that your claim’s number could come up for review — are you ready?

HHH Medicare Administrative Contractor CGS specifies that the certification of terminal illness supporting your claim must include:

1. Statement of terminal illness. A simple statement that the patient’s life expectancy is six months or less if the terminal illness runs its normal course.

2. Clinical findings that support terminal illness. The specific clinical findings (e.g., patient diagnosis and prognosis, laboratory results, rapid decline in patient status) to support a life expectancy of six months or less.

3. Hospice benefit period(s). The specific “from” and “through” dates (i.e., MM/DD/YY to MM/DD/ YY) for each period of hospice care.

4. Narrative. A synthesis of the patient’s individual clinical circumstances that support a life expectancy of six months or less and a statement attesting that the physician wrote the narrative based on their review of the patient’s medical record or an examination.

5. Physician signature and date. A legible physician signature and date (e.g., Chris Smith MD, MM/DD/YY) directly below the narrative.

6. Face-to-face encounter and attestation. A face-to-face visit by a hospice physician or hospice nurse practitioner.