Home Health Line
06/27/2016
Home care agencies should have protocols in place to give guidance and ensure correct documentation when a patient’s insurance changes after submission of the OASIS assessment.
06/27/2016
by: CMS
G0158 (Written plan of care established and periodically reviewed) remained the most common standard-level deficiency in 2015, followed by G0159 (Plan of care covers diagnoses, required services, visits, etc.), data CMS provided HHL show.
06/24/2016
Read the defendan'ts response in the Jimmo case.
06/24/2016
Read the Center for Medicare Advocacy's reply to the Secretary's response in opposition.
06/23/2016
by: OIG
Read a June 22 brief on home health fraud and abuse.
06/20/2016
Medicare Administrative Contractor (MAC) Palmetto GBA in June made another revision to a Local Coverage Determination (LCD) involving diabetic patients. Agencies now are recommended — not required — to provide frequent documentation for HbA1c tests for diabetic patients.
06/20/2016
Agencies in five states are about to begin a three-year Medicare pre-claim review demonstration that will require them to become more proactive when obtaining face-to-face documentation if they want to get paid.
06/20/2016
Medicare Administrative Contractors (MACs) will have enough staff to be able to handle the thousands of additional home health claims they’ll need to review as a result of the pre-claim review demonstration set to take place in five states nationwide, CMS claimed during a June 14 open door forum.
06/20/2016
Growth in the percentage of beneficiaries covered by Medicare Advantage plans — 31% compared with 22% in 2008 and expected to reach 40% by 2026, according to the Congressional Budget Office — indicates the cost of accepting plan enrollees only will increase for home health providers.
06/20/2016
Assign L97.213 (Non-pressure chronic ulcer of right calf with necrosis of muscle) to capture the severity of a non-pressure ulcer, such as an arterial or stasis ulcer, only when there is evidence of muscle necrosis in the wound, according to the Coding Clinic.

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