Home Health & Hospice Week
INTERMEDIARY CRACKS DOWN ON V57.1
You'd better make sure your therapy documentation is more airtight than ever. Regional home health intermediary Cahaba GBA has announced it will scrutinize V57.1 (Other physical therapy) in coming months.
However, the RHHI will limit this particular widespread review to outpatient home health patients only, it notes in a posting on its Web site. In other words, the review will apply only to Part B therapy patients. Cahaba will select home health outpatient claims with type of bill 34X, revenue code 042X and V57.1 as primary.
"The claims will be reviewed for medical necessity (e.g. compliance with [Centers for Medicare & Medicaid Services] guidelines, contractor Local Coverage Determinations (LCDs), correct billing and coding)," the intermediary explains.
Watch out: HHAs may run into high denial rates if they haven't adjusted for new coding rules that took effect in December, coding experts warn. They require using V57.1 as a primary diagnosis only (see Eli's HCW, Vol. XIV, No. 45).
Note: More details are at www.cahabagba.com/part_a/whats_new/20060505_probe.htm. For more information on home health diagnosis coding, see Eli's Home Health ICD-9 Alert at www.elihealthcare.com or by calling 1-800-874-9180.
Home Health & Hospice Week
- Patient Notices:
APPLY HHABNs TO DME, THERAPY, TRADE GROUP ADVISES
Know when to hand off ABNs to frontline staff--and when not to.
It's crunch time for [...] - Regulations:
HOW ABN SPEC SAVVY CAN STAVE OFF NON-COMPLIANCE
Check out these must-know vitals on cost estimates and pre-printed information.
If you fail to fill [...] - Compliance:
ZERO IN ON ANTI-KICKBACK, FALSE CLAIMS COMPLIANCE--OR RISK ALL
Suppliers pay millions in two recent cases.
Batten down the compliance hatches or your business could [...] - Strategy:
COMBAT RECORD GAS PRICES WITH THESE 4 TIPS
Share information on where to buy the cheapest gas.
Prices are finally leveling off at the [...] - Wheelchairs:
THERAPISTS GEAR UP FOR NEW ROLE IN MANAGING PMD PATIENTS
Know how therapists will affect the way you furnish wheelchairs under the new rule.
Wheelchair suppliers [...] - Medical Review:
INTERMEDIARY CRACKS DOWN ON V57.1
Get ready to defend your outpatient therapy claims.
You'd better make sure your therapy documentation is [...] - Industry Notes:
HOME CARE CHAINS RUN UP REVENUES WHILE PROFITS LANGUISH
Publicly traded home care companies are seeing bigger and bigger revenues, but that may not [...]
