Home Health & Hospice Week
Case Mix Changes Take Effect On M0090 Date
The 2.3 percent cut will hit a bit later. Don't expect to have an episode's worth of lag time when switching over to the new prospective payment system case mix grouper. The date you complete the OASIS assessment determines whether you'll receive this year's or next year's PPS payment. The date you enter in M0090 will set whether the 2011 or 2012 PPS grouper applies to your payment, the National Association for Home Care & Hospice points out in its member newsletter. Under the new PPS case mix system, home health agencies' payments will decrease for high-therapy episodes and increase for no- or low-therapy episodes, among other changes. (See Eli's HCW, Vol. XX, No. 39, p. 306 for more case mix change details.) The new case mix system also eliminates 401.1 (Benign essential hypertension) and 401.9 (Unspecified essential hypertension) as case mix codes, points out coding expert Lisa Selman-Holman on her blog. That also takes effect based on the M00090 date. In contrast: The 2.3 percent cut and other rate changes will take effect based on a claim's "through" date, NAHC points out. Note: See CMS's rate update transmittal at www.cms.gov/transmittals/downloads/R2356CP.pdf. The MLN Matters article is at www.cms.gov/MLNMattersArticles/downloads/MM7657.pdf.
Home Health & Hospice Week
- Medical Review:
Don't Let Top Denial Reasons Shoot Down Your Claims
Homebound status, lack of skilled need common reasons for denials. If you don't thoroughly understand -- [...] - OASIS:
Use Your OASIS To Pinpoint Medical Review Red Flags
Functional domain scores, diagnosis items can lead reviewers to your weak spots. One way to [...] - Tool:
Know When Your Patients Qualify For Home Care -- And When They Don't
Use this checklist from one HHH MAC to guide your eligibility assessments. Medical review from [...] - Compliance:
Hospices Serving Nursing Home Patients Brace For 2012 Scrutiny
OIG work plan for next year throws spotlight on this care setting. In a report [...] - Prospective Payment System:
Case Mix Changes Take Effect On M0090 Date
The 2.3 percent cut will hit a bit later. Don't expect to have an episode's [...] - Industry Note:
DME Bidding Areas Will Reach 100 By 2013
Bidding registration is now open. Chances are your patients' choice of durable medical equipment suppliers [...] - Industry Note:
Home Health Copay Threat Still Looms
Keep an eye peeled for developments in Washington regarding the so-called "doc fix." Industry members [...] - Industry Note:
Use New ABN Quick Glance Tool To Make ABN Calls
You've got newly revised instructions that go with the home health advance beneficiary notice (HHABN) [...] - Industry Note:
Make Hospice Discharge Code Change Jan. 1
Starting Jan. 1, you shouldn't use occurrence code 42 on your hospice claims when the [...] - Industry Note:
CMS Lifts One F2F Documentation Requirement
Ideally, you shouldn't be seeing any more claims denials when your hospitalized patient's documentation fails [...] - Industry Note:
MA Enrollees Increase
If you feel like your managed care headaches continue to grow, it's likely because Medicare [...] - Industry Note:
Home Health May Dodge Medicaid RACs' Scrutiny
The Medicaid RACs will soon make their debut. "Absent an exception, States will be required [...] - Industry Note:
Note LCD Denial Change
You'll get a little Christmas present from HHH MAC subcontractor National Government Services this month. [...] - Industry Note:
FBI Raids TX Agency
The fraud-fighting hammer appears to be dropping on an Alamo, Texas HHA. Rio Home Care [...] - Industry Note:
Newspaper Profile Gives Houston HHAs Bad Rap
Meanwhile, HHAs in Houston, Texas are getting a black eye in the press, thanks to [...]
