Home Health & Hospice Week

To obtain the payment you deserve under the new prospective payment system, you need to be aware of these refinements to PPS' clinical dimension.

The final rule includes these items in the clinical dimension:

M0230/M0240/M0246--Diagnoses
M0250--Therapies
M0390--Vision
M0420--Pain
M0450 & M0460--Pressure ulcers
M0476--Stasis ulcers
M0488--Surgical wounds
M0490--Dyspnea
M0540--Bowel incontinence
M0550--Ostomy
M0650--Dressing Upper Body (Functional dimension item, new to clinical dimension)
M0650--Dressing Lower Body (Functional dimension item, new to clinical dimension)
M0670--Bathing (Functional dimension item, new to clinical dimension)
M0680--Toileting (Functional dimension item, new to clinical dimension)
M0690--Transferring (Functional dimension item, new to clinical dimension)
M0700--Ambulation (Functional dimension item, new to clinical dimension)
M0800--Injectable drugs (New)

The final rule eliminates these current items from the clinical domain:

M0245--Payment diagnoses (Replaced by M0246)
M0440--Skin lesions/open wounds (Still counted in Nonroutine Supplies [NRS] calculations)
M0530--Urinary incontinence (Change from proposed rule)
M0610--Behaviors (Replaced by psych case mix diagnoses).

Source: Adapted from an Eli teleconference by Mark Sharp, BKD in Springfield, MO.