Home Health & Hospice Week

Here are 5 new supply codes you're financially responsible for.

Home health agencies will say hello to five new supplies codes and goodbye to three old ones on the home health consolidated billing list.

HHAs are responsible for payment of supplies and services on the list when patients are under a home health plan of care. "New updates are required by changes to the coding system, not because the services subject to HH consolidated billing are being redefined," the Centers for Medicare & Medicaid Services maintains in an Oct. 14 transmittal (CR 4114).

Starting Jan. 1, CMS will add to the bundling list HCPCS codes A6457 (Tubular dressing with or without elastic, any width, per linear yard), A4412 (Ostomy pouch, drainable, high output, for use on a barrier with flange [2 piece system], without filter, each), A5120 (Skin barrier, wipes or swabs, each), A4363 (Ostomy clamp, any type, replacement only, each), and A4411 (Ostomy skin barrier, solid 4x4 or equivalent, extended wear, with built-in convexity, each).

Code A5120 replaces code A5119 (Skin barrier wipes box pr), a revised definition of A4215 replaces code A4656 (Needle, any size each) and code A6025 (Gel sheet for dermal or epidermal application [e.g. silicone, hydrogel, other]) will be deleted altogether, CMS says.

There are no therapy updates this time around, CMS adds. An updated home health consolidated billing master code list is at www.cms.hhs.gov/providers/hhapps/default.asp (scroll to bottom of page).

 • A recent federal report on inhalation drug services is coming under fire from the industry. Commenting on the HHS Office of Inspector General's report questioning the need for the service fee, Apria Healthcare Inc. CEO Lawrence Higby said he was "extremely disappointed that the OIG disregarded or excluded most of the services necessary to safely and effectively provide home inhalation therapy, before reaching the conclusion that inhalation patients do not receive meaningful services."

The Lake Forest, CA-based company--which recently announced a downturn in revenues from its respiratory line--estimates the OIG excluded services that represent over 80 percent of the total costs incurred providing such services.

• HHAs struggling with OASIS accuracy can find help in the updated version of the 3M National OASIS Integrity Project Report.

The update to the 2003 report includes new techniques and questions to improve agencies' accuracy when responding to the OASIS M0 items, according to Robert Fazzi, president of Northampton, MA-based Fazzi Associates.

The new version takes into account the updates to the OASIS Question and Answers that CMS added to its Web site in June.

The report is available at no charge through the National Association for Home Care & Hospice at www.nahc.org/NAHC/CaringComm/eNAHCReport/datacharts/oasisreport2005.pdf. For more information on OASIS, see Eli's OASIS Alert at www.elihealthcare.com/spec_oasis.htm or by calling 1-800-874-9180.

• Durable medical equipment suppliers have a new tool to help educate physicians on power mobility policy changes. The DME regional contractor medical directors have produced a letter explaining the national coverage determination for mobility assistive equipment, which took effect May 5.

The letter explains the new requirement for a face-to-face examination, provides guidance on information to include in the exam report, and offers details on collaborating with physical and occupational therapists. The letter is online at www.adminastar.com/News/DMERCNews/files/DocumentationMDletter.pdf.

 • Start planning now to celebrate National Home Care Month, National Hospice Month, and National Home Care Aide Week next month. Launching a ribbon-wearing campaign, designating different days of the month to honor different types of home care staff, and sending copies of patients' thank-you letters to referring physicians are all ways to help celebrate the occasion, the National Association for Home Care & Hospice suggests.

More information, including this year's slogans and numerous celebration ideas, is at www.nahc.com/hcmonth05/celebrate.html.

• DME Region B has a new program safeguard contractor. CMS awarded the job to Columbia, SC-based TriCenturion, which will assume responsibility for medical policy, medical review and benefit integrity efforts for Region B DMEPOS claims.

AdminaStar Federal, headquartered in Indianapolis, will continue to process claims, provide customer service, address Medicare secondary payer issues, administer the appeals process, and provide education to beneficiaries and suppliers in that region.

• Mergers and acquisitions are up in the HHA market but down in the home medical equipment sector, says M&A firm The Braff Group based in Pittsburgh, PA. HHA deals in 2005 are up 50 percent over a year ago, totaling 30 transactions thus far, the firm says in its latest quarterly update. HME deals are down 13 percent for 2005 with 45 transactions.

• Medical Home Products has divested its recently acquired diabetic supplies division. The St. Petersburg, FL-based provider of medical self-test kits announced this month that it sold Strictly Diabetics Inc., a wholly owned subsidiary it acquired earlier this year. MHP hopes the move "will allow each company to concentrate on its core business," according to CEO Paul Mathis.

• Arcadia Resources is coming to Sears. The Southfield, MI-based DME supplier recently announ-ced that it opened six Sears Home Health Care Centers in the Detroit area. The centers are located inside Sears department stores and offer more than 1,000 products including mobility assistive equipment, bathroom safety products and adjustable beds.

• CS Medical and MP TotalCare are merging. Warburg Pincus, a New York-based private equity firm, recently announced that it acquired the Florida-based DME providers. It plans to merge the companies and operate them as CCS Medical.

Warburg Pincus paid $360 million for CCS and $270 million for MP TotalCare.

• Non-profits VNA and Hospice of South Texas and CHRISTUS HomeCare - San Antonio will combine their home care and hospice services in the San Antonio area, the agencies say in a release. Pending approval from parent CHRISTUS Health and its system board of directors, the agencies hope to combine services by November.