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Home Health & Hospice Week

Industry Note:

Clear Up This Question About Allowing Additional Visits

Published on Fri Mar 16, 2012

If you're not sure how specific the physician's order needs to be to allow additional visits, some advice from HHH MAC NHIC may help. In a question-and-answer summary from NHIC's Home Health Coverage and Medical Re-view Findings Teleconference held Feb. 14, a pro-vider asked the MAC if it would be acceptable for the order to include the phrase "worsening symptoms" or whether the order would have to include the specific symptoms. "Worsening symptoms" would be acceptable, NHIC responds. The MAC cites Medicare's Benefit Policy Manual in the Q&A: "Orders for services to be furnished 'as needed' or 'PRN' must be accompanied by a description of the patient's medical signs and symptoms that would occasion a visit and a specific limit on the number of those visits to be made under the order before an additional physician order would have to be obtained." The Q&A set is at www.medicarenhic.com/RHHI/billing/QAHHcoverage021412.pdf.
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