Home Health & Hospice Week

Get ready to justify your services.

A quick way to lose an entire episode’s reimbursement is to fail to have a matching OASIS data set in the system.

That’s one of the many things Medicare Ad-ministrative Contractor Palmetto GBA will be looking for when it launches a new review of claims with a 2BGL* HIPPS code. That code represents an early episode with 16 to 17 therapy visits and moderate clinical and functional domain scores.

Other items on Palmetto’s hit list include an itemized supply and/or DME list; a copy of the psych nurse approval letter from Palmetto when applicable; face-to-face encounter documentation; for management and evaluation of the care plan, a physician’s brief narrative documentation describing the clinical justification for the services; therapy documentation including measurements; and much more, according to a new post on Palmetto’s website. For a free link to the post, email editor Rebecca Johnson at rebeccaj@eliresearch.com with “2BGL Review” in the subject line.