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Home Health & Hospice Week

Prospective Payment System:

Brace For Case Mix Diagnosis Coding Changes In 2013

Published on Thu Aug 23, 2012

Will you take a hit on resolved diagnoses?Prepare to see a reduction in home health reimbursement if a proposal about OASIS item M1024 is finalized for next year.The 2013 home health prospective payment system proposed rule published in the July 13 Federal Register makes sweeping changes to the diagnoses you can report for case mix points in M1024 -- Payment Diagnoses. The changes to M1024 would have a devastating effect on home health agencies, warns coding expert Judy Adams with Adams Home Care Consulting in Chapel Hill, N.C.The Centers for Medicare & Medicaid Services wants to restrict use of M1024 to fracture codes alone, the rule indicates. CMS proposes changes to the grouper to limit the code range that can be reported in this item.Coders generally list acute fracture codes in M1024 because it goes against coding guidelines to assign these codes in M1020/M1022 once the acute care is complete, says [...]
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