Home Health & Hospice Week

Home health agencies wanting to avoid nonroutine supplies billing traps can follow these four steps:

1. Learn how to bill supplies. This could require internal policies and procedures work, depending on how you track NRS now. HHAs have only two supplies codes to use on claims -- 0027 for general supplies or 0623 for wound care supplies. Charges should include the cost of the supplies and your markup.

If you're not sure how to include the charges on your claim, you need to get in touch with your software vendor before the Oct. 1 deadline to find out, urges Michelle Enger with Optimal Reimburse-ment Strategies in Clearwater, FL.

2. Double-check your claims. You should conduct pre-billing audits to be sure you're billing NRS correctly, suggests Melinda Gaboury with Healthcare Provider Solutions in Nashville, TN.

3. Change the fifth digit. While you should beware of changing the fifth digit of the HIPPS code in the wrong circumstances, you should learn what the right circumstances are -- when you provide no NRS in an episode. Review the differences between routine and nonroutine supplies for staff.

4. Correct RTP'd claims. If your best efforts fail or you can't get geared up in time, you'll have to correct the claims that are returned to you. RTPing instead of rejecting claims is a "safety net" the Centers for Medicare & Medicaid Services is providing to agencies, Enger says. "They will simply add the supplies and send the claim back for processing."

Note: For more NRS billing tips, an explanation of the payment categories and reimbursement amounts, and other NRS information, see Eli's HCW, Vol. XVII, No. 16, p. 122.