Home Health & Hospice Week

Background: In the new year, the Centers for Medicare & Medicaid Services started requiring eight new billing codes in addition to the existing six codes for home health agency services (for a list of the codes and tips on how to use them, see Eli's HCW, Vol. XIX, No. 44-45, p. 346). Those include new nursing codes for RN management and evaluation of the plan of care (G0162), LPN or RN observation and assessment (G0163), and LPN or RN training and education (G0164).

HHAs must be using new and expanded G codes for 2011 visits, CMS's Lori Anderson reminded HHAs in the Jan. 19 Open Door Forum for home care providers.

"The January 1, 2011, effective date means that these new and revised G-codes should be used for home health episodes beginning on or after January 1, 2011," CMS explains in MLN Matters Article MM7182.

Watch out: "CMS contractors set up their systems in such a way that claims with start of care dates prior to Jan. 1, 2011 will be rejected if they include the new G codes," the National Associationfor Home Care & Hospice warns.

In the forum, one caller expressed frustration with having to choose just one G code to report per visit. It "seems like we do all of those things that are on the G code list at our visits," the caller said.

Tip: "In choosing which G code to report, ask yourself what is the primary reason I'm going out there for a visit," Anderson recommended. "Most of the time that will be what you spend the most time on, but not necessarily."