Home Health Line
03/24/2023
A new outcome measure is on the horizon for agencies. It will impact your Care Compare results, and potentially future HHVBP reimbursement.
03/24/2023
Now, over three years since the implementation of PDGM, some agencies are still using questionable encounter (QE) codes as primary diagnosis leading to unnecessary claims rejections.
03/24/2023
Instead of the clinicians, coders are often being asked to assign symptom ratings for M1021/M1022. But they don’t have much to go on except best guesses based on documentation. Inaccurate SCRs lead to an inaccurate reflection of the patient condition, an incomplete or misdirected plan of care and incorrect coding.
03/24/2023
The five certification components must be present in the record — that includes the documentation of the date of the encounter as well as the encounter. That can only be noted once the encounter has been completed — there is no valid certification that the encounter “will occur.”
03/24/2023
Make sure all of your documentation is in order now to justify use of Payment Protection Program (PPP) funds as the government now has 10 years instead of five to investigate potential fraudulent use of funds.
03/24/2023
These 10 questionable encounters accounted for nearly 28% of the 687 questionable encounter codes listed as primary in the month of December 2022, according the Strategic Healthcare Programs’ (SHP) National Client Database.
03/16/2023
Industry comments regarding proposed changes to Medicare Advantage (MA) plans suggest CMS isn’t providing the enforcement necessary to ensure patients are receiving home health services as ordered by the physician.
03/16/2023
As more patients look to receive care at home, there’s an opportunity for home health agencies to take on higher acuity patients and become the referral partner of choice for hospitals and other providers.
03/16/2023
Coders could have a way to capture a post-acute encounter for sepsis aftercare if a proposal presented during the March ICD-10 Coordination & Maintenance Committee meeting gets finalized.
03/16/2023
A recent home health fine for employing an individual on the Medicare exclusion list serves as a reminder to home health agencies just how important it is to check the list of excluded and suspended individuals.

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