Home Health & Hospice Week

Every year, home health agencies must adjust to some new codes being added and deleted from the consolidated billing list for the Home Health Prospective Payment System. But a new addition addressing treating wounds with oxygen scheduled for April 1 may be more problematic than usual.

"The HH consolidated billing code lists are updated annually, to reflect the annual changes to the HCPCS code set itself," notes the Centers for Medicare & Medicaid Services in CR 10374. This time around, CMS is adding A4575 - Topical hyperbaric oxygen chamber, disposable (Hyperbaric o2 chamber disps) to the list.

Reminder: "Services appearing on this list that are submitted on claims to [the] MAC will not be paid separately on dates when a beneficiary for whom such a service is being billed is in a home health episode (that is, under a home health plan of care administered by an HHA)," explains an accompanying MLN Matters article on the change. Instead, CMS directs providers to turn to the HHA for payment.

A4575 is being added to the bundling list this year because CMS recently reversed its national coverage decision excluding the service from coverage, notes the National Association for Home Care & Hospice. But "CMS decided that no NCD is appropriate at this time concerning the use of topical oxygen for the treatment of chronic wounds," the agency notes in CR 10220. Instead, "Medicare coverage of topical oxygen for the treatment of chronic wounds will be determined by the local contractors," the transmittal says.

Stay tuned: NAHC "is concerned that this treatment will be expensive for agencies to provide and is seeking clarification from the MACs on how they intend to address coverage decisions of topical hyperbaric oxygen treatments for home health and hospice patients," the trade group says in its member newsletter.

See the transmittals at www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017-Transmittals-Items/R3923CP.html and www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017-Transmittals-Items/R3921CP.html.