Wound care therapy codes top additions. Home health agencies, suppliers and hospitals will have to watch out for some new codes bundled into the home health prospective payment system starting Jan. 1.
HHAs have to pay for the supplies and services out of their PPS payments. Accordingly, suppliers and hospitals will be denied for the supplies and therapy services provided to patients under a home health plan of care, and have to seek payment from the HHA.
The Centers for Medicare & Medicaid Services is deleting three HCPCS codes for male external catheters with different features (A4347, A4324 and A4325) and replacing them with one code for the devices (A4349).
CMS is adding codes for a chest drain valve (A7040), chest tube accessories (A7041), an exhalation port (A7045) and a trach plug (A7527).
CMS is replacing a general wound care code (97601) with two more specific debridement codes (97597 and 97598). And it is adding two codes for wound vacs (97605 and 97606). More details are in CR 3525 dated Oct. 29, to be posted at
www.cms.hhs.gov/manuals/transmittals/comm_date_dsc.asp. Payment of medically necessary power wheelchair claims in the Houston, TX area is just about back to normal after the Operation Wheeler Dealer slow-down, a CMS official said in the Nov. 9 Open Door Forum for home care providers. But Seth Johnson of Pride Mobility Corp. reported continuing problems obtaining payment for claims in that area.
Meanwhile, Erik Sokol with the Power Mobility Coalition voiced a concern with the high number of wheelchair claims being subject to additional development requests (ADRs).
CMS soon will issue policies on wheelchair coverage, wheelchair coding and power-operated vehicles (scooters), an official noted in the forum. Salaries increased 3.3 percent from 2003 to 2004 for HHA executive directors and CEOs, according to a new salary and benefit survey from Oakland, NJ-based Healthcare Compensation Service. The base median salary was $93,200. "Voluntary" HHAs were at the high end of the scale with a median $129,535 salary for executive directors, while hospital-based HHA directors had the lowest pay with a median $87,500 salary.
Management salaries increased 3.7 percent and registered nurses' salaries grew 3.9 percent from 2003 to 2004, says the survey conducted in conjunction with the National Association for Home Care & Hospice.
Maryland will launch a consumer-directed demonstration plan called "New Directions," CMS says in a release. Under the waiver plan, beneficiaries will "be able to select and direct their personal assistants and use a portion of their individual budget for non-traditional goods and services," CMS explains.
"Allowing persons with disabilities to engage in 'self-direction' is a high priority for the Bush Admin-istration," CMS Administrator Mark McClellan says in the release. "Self-direction is a proven approach to higher beneficiary satisfaction for the same or lower [...]
