Home Health & Hospice Week

A big shift in coding could prove CMS right that agencies were gaming. Now that it's the new year, you can no longer earn case mix points for two common hypertension codes. But that doesn't necessarily mean your agency has to take a reimbursement hit. Other comorbidities and more specific coding may soften the blow. In the prospective payment system final rule for 2012, the Centers for Medicare & Medicaid Services said, "Beginning with M0090 dates of Jan-uary 1, 2012, 401.1 Benign essential hypertension codes and 401.9 Unspecified essential hypertension are removed from the HH PPS case-mix system. Specifically, 401.1 and 401.9 diagnosis codes will no longer result in additional points when computing the HIPPS codes." Lack Of Documentation Led To  Case Mix Change CMS eliminated case mix points for codes 401.1 and 401.9 because agencies were using them inappropriately, says consultant Lynda Laff with Laff Associates in Hilton Head [...]