Today is the day!! The new ICD-10 codes that were released are now effective!! Do not let your billing be delayed due to a coding glitch. Remember that every episode that has an encounter date of 10/01/2021 and after will have to be reviewed for any new code updates. The code that will probably create…
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COVID-19 Employee Tracking
An important aspect of your COVID-19 Plan is maintaining a log of COVID-19 positive employees. This document details all your employees who have a confirmed infection regardless of the source (work-related or otherwise). Remember that this log must be consistent with your OSHA 300, 300A, and 301 forms and be maintained in the confidential medical…
COVID-19 Compliance
Much confusion and angst has been brought about in the recent announcement of President Biden’s new COVID mandate. This along with changes to the OSHA ETS have left many home health and hospice providers wondering what to do. First of all, neither of these new regulations have been implemented yet—so take a deep breath. The…
Medical Necessity
One of the most common reasons for home health claims denials revolve around medical necessity for skilled nursing services—denial code 5HN18. During the first quarter of 2021, the Medicare Administrative Contractors identified this denial reason among the top five. The solution boils down to a good understanding of skilled nursing services and documentation, documentation, documentation. …
National Preparedness Month
A new month is upon us, and the designation of it being National Preparedness Month could not be more timely. The sheer number of things Americans are currently dealing with is overwhelming—hurricanes, flooding, wildfires, tornadoes, COVID variants, and more and more and more. Frankly, we are tired. When is National “Gimme A Break” Month??? Sadly,…
Additional Document Requests
Additional Document Requests (ADRs) strike fear into the hearts of most home health and hospice providers. One of the leading reasons for claim denial results from providers not responding to ADRs. That, in itself, will lead to more scrutiny. Providers need to ensure they have a clear cut ADR process including prompt identification of the…
Hospice Care Index
Believe it or not, the Fiscal Year 2022 for hospice begins in just over a month—on October 1st. Among the changes finalized by CMS is a new item to be publicly reported no sooner than May 2022. The Hospice Care Index (HCI), in effect, replaces the seven HIS items that will be removed from public…
Targeted Probe and Educate Resumes
CMS has announced it is restarting the Targeted Probe and Educate (TPE) program. It has been in suspension since the COVID-19 public health emergency. The program is designed to assist agencies to reduce their claim denials as common claim errors are corrected. The Medicare Administrative Contractors (MACs) use data to identify providers and suppliers who…
Hospice Final Rule
The hospice final rule for Fiscal Year (FY) 2022 was issued on July 29th. This 226 page document–CMS-1745-F–addresses a number of changes including the hospice wage index, payment rates, and aggregate cap amount for FY 2022. Specifically, hospices who submit quality data will receive a 2% raise in payment rates. Hospices who do not submit…
Hospice Expansion
As the elderly population increases along with chronic and age-related diseases, the hospice industry is projected to expand over the next few years. In surveys performed by AARP and others, it’s not surprising to find that most adults have a preference to age in place as long as possible. Earlier this year, MedPAC reported a…
