4% of home health claims in review lacked valid FIPS code. Home health access in rural areas is a real problem, as evidenced by recent MedPAC meeting discussions, among other things. But a new OIG report shies away from acknowledging [...]
Therapy episodes would get reimbursed less. If your claims are dominated by episodes with high therapy, no recent hospital stays, or patients with behavioral health conditions such as schizophrenia, bipolar disorder or drug addiction, Medicare’s draft for HH PPS payment [...]
Your stake in the wage index lottery is going to get higher next year, if a proposal from CMS becomes final. The Centers for Medicare & Medicaid Services wants to increase the labor portion of the prospective payment system rate [...]
Receive your rightful reimbursement with a case management approach to diagnosis coding. Even if you have the most accurate coder in the world, if the clinician's answers and medical record documentation don't support the choices in M1020 (Primary diagnosis), M1022 [...]
Open the lines of communication with your clinicians to improve diagnosis coding accuracy. Taking a case management approach to diagnosis selection could gain your agency hundreds of dollars. Like most home health coders, Jan McLain, RN, BS, LNC, COS-C, HCS-D, [...]
PPS final rule brings major changes to reimbursement for therapy, supplies, coding.You'll have to do more with less under the prospective payment system makeover that just became final.The Centers for Medicare & Medicaid Services issued the home health PPS refinements [...]
Just because something is 'bundled' doesn't mean you can't bill itMyth: If two procedures are listed as "bundled," you can never bill them together.Reality: Every surgery is different, and you need to look at the specific circumstances, urges Joshua Klinge [...]
Your surgeon could gain an extra $1600 for osteotomyMyth: If two procedures are listed as -bundled,- you can never bill them together.Reality: Every surgery is different, and you need to look at the specific circumstances, urges Joshua Klinge with Neuro [...]
First major PPS refinements tackle hot button issues like therapy, LUPAs.Home health agencies may alternately cheer and boo as they read through the massive proposed rule on the prospective payment system released April 27, but the boos will likely win [...]
MedPac pushes freeze at House hearing.The final decision on 2007 Medicare payment rates is probably at least half a year away, but the battle over home care reimbursement is already escalating into an all-out war.In the Medicare Payment Advisory Commission's [...]
