Home Health & Hospice Week
Industry Note:
Good News In Observation & Assessment Clarification
Published on Thu May 10, 2012
Wondering exactly what's required to justify billing observation and assessment code G0163? Well, direct physician contact shouldn't be among the requirements. So said CMS officials in the April 11 Open Door Forum for home care providers. HHAs are being told that the clinician must have directly contacted the physician for the visit in which the code is used, a caller told CMS in the forum. That's not the case, said a CMS rep. But the record must show that there was a reasonable potential for a complication or acute episode, the rep added. (For more tips on billing O&A, see Eli's HCW, Vol. XXI, No. 17, p. 130).
Other Articles in this issue of
Home Health & Hospice Week
- Pay For Performance:
Medicare Chugs Closer To Home Health P4P System
Will you have to pay for your patients' high rehospitalization rates? The pay for performance [...] - Reimbursement:
Start Working On Your HH Compare Measures To Prep For P4P
Tip: Put some resources into quality improvement. The timeline for a home health pay for [...] - Fraud & Abuse:
2 Home Care-Related Defendants Plead Guilty After Record-Breaking Fraud Bust
Industry must combat fraud rep. The feds just charged 107 individuals nationwide with Medicare fraud [...] - Finance:
Home Care Companies' Earnings Suffer In Latest Quarter
Reimbursement cuts, face-to-face write-offs mar chains' profits. The Medicare reimbursement climate is getting rougher, and [...] - Industry Note:
Medicare Funds Projects That Use Home Care Strengths
Educating patients, implementing telehealth figure in Innovation awards. The Centers for Medicare & Medicaid Services' [...] - Industry Note:
Deadline For Comments On 1-Year ICD-10 Delay Is Nearly Here
Providers that have an opinion -- either positive or negative -- on the proposed new ICD-10 compliance [...] - Industry Note:
Get To Know This New Code
When a patient passes away, you have another code to put on your claim. CMS [...] - Industry Note:
Home Care Earns Top Profits, Newspaper Highlights
The home care industry is having to fight another charge threatening its reputation. Once again, [...] - Industry Note:
Therapy Edits Focus On High Utilization
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MAC Calls Providers On The Carpet For 5010
Think that your HHH Medicare Ad-ministrative Contractor hasn't noticed that you aren't submitting claims in [...] - Industry Note:
CMS Issues New Billing Instruction For Hospices
Starting Oct. 1, hospices need to note a billing wrinkle in the new 5010 format. [...] - Industry Note:
Good News In Observation & Assessment Clarification
Wondering exactly what's required to justify billing observation and assessment code G0163? Well, direct physician [...] - Industry Note:
NC Agency Owner Faces Fraud Charges
A North Carolina home health agency owner has pled guilty to Medicaid fraud. Prose-cutors charged [...] - Reader Question:
Don't Let Ignorance Cost You Therapy Cap Dollars
Use HIQA to find out where your non-homebound patients stand on their caps. Question: Where [...]
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