Home Health & Hospice Week

Reviewers shoot down claims for certification,terminal prognosis problems. You could wind up owing money back to Medicare if your documentation on myeloma and lymphoma patients is sloppy. Regional home health intermediary Cahaba GBA is launching a widespread review of hospice claims with diagnoses of 202.xx (Other malignant neoplasms of lymphoid and histiocytic tissue) and 203.xx (Multiple myeloma) and with lengths of stay greater than 180 days. In a probe review, Cahaba reviewers shot down most claims due to "missing, incomplete or untimely certifications and the six-month terminal prognosis not being supported in the medical record," the intermediary says in its March newsletter to providers. Tip #1: The cert period dates must be clearly identified on the form, Cahaba instructs. "Simply having the statement 'third benefit period' is not enough to be able to tell which certification period the physician is signing," it says. Tip #2: Don't rely on your diagnosis [...]