Home Health & Hospice Week

You may want to review three vital OASIS items, or risk your Medicare payment in medical review. Home health agencies' number-one denial reason in the Comprehensive Error Rate Testing program was "Documentation does not support OASIS responses/HIPPS code billed," Home Health & Hospice Medicare Administrator Contractor CGS says in its March newsletter for providers.

"A common error was with M0130 (Therapies) where the OASIS response did not reflect the therapies the patient received, such as a PEG tube, or a PICC line," CGS explains. "Another common error was with medications, and OASIS items M0800 and M02030 where the OASIS responses were not supported in the documentation submitted to the CERT review contractor."

HHAs' number-two denial reason was the agency failing to secure the physician's signature on orders/the POC before billing. "Your agency should have an internal review process in place to ensure that a claim is not submitted until the signed POC/ orders have been received and meet the signature guidelines," CGS instructs. That goes for verbal orders too.

Tools: Bone up on signature guidelines with CGS's quick resource tool, "Signature Guidelines for Home Health and Hospice Medical Review," at www.cgsmedicare.com/hhh/medreview/sig_guidelines.pdf. CGS's March newsletter is at www.cgsmedicare.com/hhh/pubs/mb_hhh/2012/03_2012/index.html.