Home Health & Hospice Week

Add a new code to the list of items and services you are responsible for covering under your prospective payment system amount. The Centers for Medicare & Medicaid Services has added A4459 (Manual Pump Enema System, Includes Bal-loon, Catheter And All Accessories, Reusable, Any Type) to the home health consolidated billing non-routine supply code list, the agency says in MLN Matters Article MM8893. The change takes effect Jan. 1.

"Code A4459 is added because of its similarity to code A4458, which has been subject to HH consolidated billing since 2003," CMS explains in the article online at www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM8893.pdf.

Reminder: "With the exception of therapies performed by physicians, supplies incidental to physician services, and supplies used in institutional settings, services appearing on [the home health consolidated billing] list that are submitted on claims to Medicare contractors will not be paid separately on dates when a beneficiary for whom such a service is being billed is in a home health episode (i.e., under a home health plan of care administered by a home health agency)," CMS explains. "Medi-care will only directly reimburse the primary home health agencies that have opened such episodes during the episode periods."