Home Health Line
04/23/2026
Make sure the reason for continued care is clear, particularly with repetitive tasks month after month, as a new audit shows CMS’ search for fraud, waste and abuse is now targeting home health stays for 361 days or longer. These medical reviews of years-old claims have high stakes, with Medicare contractors ready to claw back perceived overpayments.
04/23/2026
Ensure that unplanned discharges are completed properly — including the OASIS — and that all other documentation complies with CMS requirements. Failing to accurately note the patient’s status at discharge could impact scoring on publicly reported measures that drive reimbursement and star ratings.  
04/23/2026
Get ahead of potential roadblocks when providing in-home care for veterans by taking time to understand the U.S. Department of Veterans Affairs (VA) processes. The VA functions differently from other payors, and agencies that fall behind on authorizations could end up providing care that doesn’t get reimbursed.  
04/23/2026
New proposed codes could soon identify surgical wounds left open on purpose. 
04/23/2026
Proposed changes to the ICD-10-CM code set include new codes for personal history of Clostridioides difficile (C. diff) infection, a low body mass index (BMI) and more.  
04/23/2026
Key documentation at the start of care continue to lead reasons for denial under Targeted Probe and Educate (TPE) reviews. Requirements around the face-to-face encounter, the plan of care and certification stand out in the TPE denials for the last three months of 2025.  

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