home health

  1. T

    Wiki OP PT / Home Health

    We are an out-patient physical therapy clinic with a scenario I would love some feedback on. We have a patient that has been treating at our out-patient physical therapy clinic for years. Recently, unknown to us, he was assigned to home health. During his home health confinement he left his...
  2. podcoder70

    Wiki 97597 and 97610 performed in home

    Please help me find information as to the coding rules for these "sometimes" therapy codes as related to treatment provided by an MD or FNP NOT employed by the home health agency. The two codes are being denied, the diagnosis codes are not the issue. POS is 12. Patients are being followed by...
  3. K

    Wiki Billing of supervision of patient under home health care CPT code 99347

    Hi, I have been researching the billing of 99347 for the care provided for a patient while they were under a home health agency. The patient was admitted in and out of inpatient hospital status during the 4 month period. There is a Home Health detailed episode report that was updated per month...
  4. K

    Wiki Bullous pemphigoid Home Health ICD 10 coding ??? HELP!!!!!

    I have a patient admitted from the hospital to home health and I am having difficulty coding the wounds for Bullous pemphigoid. I have the diagnosis for L12.0 Bullous pemphigoid.... I have the Z48.00, however, I am unsure about each wound ICD 10 code. I know they are autoimmune blisters that...
  5. M

    Wiki Injection given in patient's home

    The office I work for (outpatient behavioral health) is planning to start having nurses go to patient's homes to administer psychiatric medication injections. Is this billable as "incident to" since the provider is not in the building where the patient is having the injection done? If not, is...
  6. M

    Wiki GA modifier during Home Health Episode

    Hi! I am having an issue with one of my practices that provides wheelchair management services by PT's and OT's for people with long term disabilities. They are occasionally running into discovering that the patient is within a Home Health Care episode. The services they provide CAN NOT be...
  7. C

    Wiki C.Washington BSN, RN CPC-A

    I am interested in obtaining a full time, part-time, or PRN medical coding position. I am a Bachelor prepared Registered Nurse with 7 years of experience in a wide variety of areas. I completed coding classes through AAPC while in high school and obtained my CPC-A certification in 2010. I have...
  8. J

    Wiki Surgeon Billing for Home Health Certs and Recerts (G0179 and G0180)

    Is anyone billing for surgeons doing home health certification? If so, are you getting denials when the certification occurs during the global period of their surgical procedure? Prior to the transfer from Cahaba to Palmetto, we did not receive very many denials, but now most of these charges...
  9. C

    Wiki NUBC and Occurrence Code 42 for Home Health Discharge Claims UB04

    Does anyone know about using Occurrence Code 42 in UB04 Field Locator 31 for discharge (321 or 324 type of bills) and if that is still a rule for Home Health? (I know it changed for Hospice in 2012). Thanks!
  10. L

    Wiki Home Health and DME

    We are having an issue for providers who do wound care. They see a patient, debride the wound, order collagen and other wound care items to be sent to the patients home so they can change their dressing in between debridements. Unbeknownst to us, the patient is seen by a Home Health nurse and...
  11. W

    Wiki Ordering Referring

    Can someone tell me which Types of bills for Part A require an ordering/referring physician on the UB for diagnostic test or DME supplies ordered
  12. T

    Wiki Home Health Certification G0179 and G0180 Question

    I work at a rehab hospital and our physicians certify Home Health services. In the past we always billed when we received a 485 form from the Home Health Agency. I'm finding that I don't always get those forms. I depended on those to confirm that the patient started home health. From what I've...
  13. K

    Wiki Billing S codes to the VA?

    Hello, I do billing for a home health agency and I am rebilling some old claims to the VA. I found some claims that are for home health aide services. Some of the claims are being billed as S9125, respite care in the home, per diem, and some are G0156, services of home health / health aide in...
  14. M

    Wiki g0179,g0180

    If my physician becomes the medical director for a home health agency, are we still allowed to bill certifications and recertifications for that agency?
  15. K

    Wiki Need help with Home Health!!

    I am really in need of some general assistance with diagnosis coding for Home Health. I am a CPC and work for a Home Health Agency doing their billing, and they have asked me to start coding on the Oasis SOC, but I have general questions... 1. Is it accurate to say that you can only code from...
  16. S

    Wiki CPC 12yr experience in medical field looking for remote full time/part time

    SKILLS •Outpatient and Inpatient Coding •ICD-10-CM, ICD-10-PCS •CPT/HCPCS Level II •Health Information Management •CMS 1500 and UB-04 Claim Forms •Healthcare Reimbursement •Medical Terminology & Anatomy •Pharmacology & Pathophysiology •3M Encoder / 3M Reference Software...
  17. K

    Wiki Home Health - skilled nursing units

    I do commercial billing for a home health agency. We use S9123, "nursing care, in the home, by registered nurse, per hour" for each skilled nursing visit, specifically for billing United Healthcare. The problem is that the claims are auto generated and sometimes they will have multiple units for...
  18. M

    Wiki HELP!!!! Hopice/Home health billing!

    I work for a Home Health agency and have billed claims for a patient beginning on 5/3 the patient was discharged from Hospice on 5/2 the patient's insurance (Humana) has denied the claims stating "due to the fact that the patient was under hospice care." I have appealed the decision showing that...
  19. E

    Wiki Radiology Services Recouped by Medicare for a Home Health Patient

    I need some help with billing radiology services provided to a home health patient. We have been getting recoupments from Medicare on our radiology claims when the patients are assigned to home health. We've tried billing the home health agency in place of Medicare, and the home health agency...
  20. J

    Wiki Aftercare coding

    Hello, I am a new Home Health coder. I am working on codes for aftercare for a hip replacement. The procedure was May 26th, a little over a month ago. The clinician listed residual weakness and gait abnormality as diagnoses. My question is, at what point are these separately coded and not...
  21. S

    Wiki 99601 clarification

    I have a question in regards to Home Infusion Nursing Visits and to when to use 99601 - Home Infusion/Specialty drug administration, per visit over S9123 - Nursing Care , in the home by registered nurse, per hour. The question is whether or not the nurses have to administer the drugs directly...
  22. N

    Wiki Lab services for Home Health patients- covered/not covered by Medicare??

    Question: A client (independent lab) is working with an Assisted Living Facility to provide lab services to its residents. The ALF has stated that when their residents are under home health care, "they don't get paid for lab services". Would laboratory services not be reimbursed by Medicare to...
  23. C

    Wiki Post chemo monitoring

    Would V58.69 be an appropriate code for a home health agency to use as primary dx for monitoring a patient currently on chemotherapy, but not administering it? Is there another code that would be better?
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