Home Health & Hospice Week

Do you know how to claim disposable NPWT?

As Jan. 1 approaches, home health agencies are scrambling to get up to speed on new 2017 billing rules.

For example: Billing procedures for disposable Negative Pressure Wound Therapy devices in particular seem to be throwing some HHAs, judging from the callers to the Nov. 16 Home Health Open Door Forum. Multiple callers asked how to bill for both the NPWT device and service.

The wound therapy furnished with replacing the device is included in the two CPT codes for disposable NPWT, a Centers for Medicare & Medicaid Services official explained. In other words, the NPWT device and service are covered by one combined CPT code. Agencies may bill those codes on Type of Bill 34x. If the agency furnishes non-NPWT services during a visit, that should be reported separately on TOB 32x.

The 20 percent copay amount you bill the patient is based on the NPWT code billed on 34x only, a CMS staffer also confirmed.

Resource: You can find details of how the 2017 Home Health Prospective Payment System billing changes will work in a new Medicare transmittal, a CMS official pointed out. Billing specs are in 71-page transmittal CR 9736 at www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3655CP.pdf.

Other home health issues raised in the forum include:

• PEPPER reports. Home health agencies are failing to take full advantage of a free benchmarking tool from Medicare.

Only 24 percent of Medicare HHAs have accessed their PEPPER reports, while 56 percent of Medicare hospices have, CMS’s PEPPER contractor said in the call. Home health PEPPER reports cover six risk areas.

You can access the reports and other related materials at www.pepperresources.org.

• OASIS-C2. You didn’t miss it — the final version of OASIS-C2 is still not out. The Office of Management and Budget still hasn’t approved it, even though it’s scheduled for Jan. 1 implementation, a CMS source said. Stay tuned for an announcement on final OMB approval.