Home Health & Hospice Week

Education article for referring physicians explains their diagnosis coding duties.

With the Patient-Driven Groupings Model only weeks away, Medicare’s issuances on the topic are coming at a faster pace than ever before.

For example: The Centers for Medicare & Medicaid Services has issued a document on “OASIS Considerations for Medicare PDGM Patients — Transition.” The new resource “provides PDGM transition guidance including OASIS time point, data set version and M0090 Date Assessment Completed considerations for patients where resulting assessments must provide the Health Insurance Prospective Payment System (HIPPS) code for a PDGM payment period that begins January 1, 2020 or later,” CMS explains.

The one-page document is at www.cms.gov/files/document/oasisconsiderationspdgm-transition111419.

CMS also has released two new MLN articles containing PDGM overviews — one for referring physicians and one for home health agencies themselves.

The physician article, SE 19027, “includes eligibility criteria for Medicare home health services as well as some information on certification in addition to PDGM,” CMS explains in a message to providers. “The section titled ‘The Importance of Diagnosis Reporting and Physician Documentation Under the PDGM’ goes into more detail about the information physicians will need to provide to home health agencies.”

The HHA summary, SE 19028, “provides a more detailed overall description of the key components of the PDGM” and “goes into greater detail,” CMS says. “This is a good summary overview of the PDGM.”

The physician PDGM article is at www.cms.gov/files/document/se19027 and the HHA article is at www.cms.gov/files/document/se19028.