Home Health & Hospice Week
MAC To Docs: Get Your HH Coding Together
Do you need help getting your referring physicians to provide the documentation necessary for PDGM billing? If so, HHH Medicare Administrative Contractor National Government Services would like to lend a hand. In a new article on its website, “What Physicians Need To Know: Home Health Patient-Driven Groupings Model,” NGS tells physicians “your attention to timely signing of orders and the home health plan of care will greatly impact the ability of home health agencies to bill Medicare in a timely way.” Coding: “It is very important that the principal diagnosis be as specific as possible,” NGS also tells docs. “Reimbursement to the home health agency under PDGM for your ordered services in part is based on assignment to one of 12 clinical groups, which represent the primary reason the patient requires home care. Vague, ill-defined, or symptom diagnoses cannot be reported as the principal diagnosis under the PDGM.” NGS doesn’t overlook comorbidity coding. “It is also important to include the secondary diagnoses (i.e., comorbidities) as the presence of certain comorbid conditions will also adjust home health payment to help ensure that payment is in alignment with home health resource needs,” the MAC tells physicians. For a free link to the article, email editor Rebecca Johnson at rebeccaj@eliresearch.com with “NGS Physician Article” in the subject line.
Home Health & Hospice Week
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