Hospice:
Proving Services Unrelated To Terminal Dx May Get Harder
Published on Tue Mar 15, 2011
Many hospice complaint surveys are underway, CMS says. It may be wise to beef up your documentation for services your hospice patients receive that aren't related to the terminal diagnosis. Under Medicare payment rules, the hospice per diem payment rate does not have to cover services that are unrelated to the terminal diagnosis for the patient. But regional offices for the Centers for Medicare & Medicaid Services are seeing "misunderstandings" about what fits into that category, CMS's Lori Anderson said at the National Association for Home Care & Hospice's March on Washington conference March 28. "A terminal diagnosis is not one ICD-9 code," Anderson emphasized to attendees. At the end of life, "almost everything" is related to the terminal condition. "It's the exception and not the norm if it's not related," she said. The ROs are seeing cases where hospices classify anything not related to one ICD-9 code -- the patient's [...]