Home Health & Hospice Week
Peruse This Target List For Risk Area Clues
Make sure you are documenting your high therapy cases extremely well.
If you’re wondering where you might be vulnerable to takebacks or even fraud and abuse charges, one HHH MAC’s list of medical review topics may give you a hint.
Medicare Administrative Contractor Pal-metto GBA lists 12 home health topics in its newly released "active medical reviews" list. High amounts of therapy figure in all but one of the 11 HIPPS codes targeted: 1BGP* 0 - 13 Visits, Lowest Scores in the Clinical and Functional Domains and Maximum Score in the Service Domain.
Therapy also is not a factor in Palmetto’s non-HIPPS-code focused review topic, "Aggregate Length of Stay and Disbursement/Beneficiary."
Palmetto also lists two broad hospice topics: lengths of stay for all non-cancer diagnoses, and hospice services furnished in a skilled nursing facility (indicated by site of service code Q5004).
Tip: You can check out the latest NCLOS benchmarks against which Palmetto is measuring you in an Aug. 25 post on its website. The data covers the first half of 2014. Email editor Rebecca Johnson at rebeccaj@eliresearch.com with "NCLOS" in the subject line for a free link to the website.
Home Health & Hospice Week
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