While many of the most common hospice principal diagnoses remained the same as previous years, one code, I63.9 (Cerebral infarction, unspecified), stood out to experts for making the list.
Hospice experts were surprised to see I63.9 (Cerebral infarction, unspecified) among the top 20 reported hospice principal diagnoses.
CMS is moving forward with the hospice Special Focus Program, effective January 1. Unfortunately, it’s too late for hospices to make changes to avoid being selected for the program.
As CMS takes a closer look at hospice documentation, many of the technical mistakes made around documentation at the Start of Care could cause denials.
It is important that hospice coders accurately capture the terminal diagnosis and understand when it would be appropriate to change the diagnosis to ensure the patient is receiving the appropriate care and interventions.
As Medicare Advantage (MA) plans participating in the Value-Based Insurance Design (VBID) model continue to add palliative care offerings, hospice providers weighing whether to partner with these plans should take a look at how competitors have been responding to MA opportunities.
If finalized, the new rule would require a marriage and family therapist or a mental health counselor as options “depending on the preferences and needs of the patient,” according to CMS.
CMS is making good on promises to address fraud, waste and abuse in the hospice system, including a variety of survey and compliance measures to weed out bad actors and address broader quality concerns.
While families depend on hospices to provide symptom management and support, 25% of families report that they didn’t receive training from the hospice to care for their loved ones.
Hospices that embrace tech tools will have a leg up when it comes to avoiding audit risks, improving quality, showing value to payors and positioning for value-based care.


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