Why Your P&P Manual Must be as Unique as Your Agency

With the new Conditions of Participation (CoPs) going into effect January 13th, QIRT consultants have been receiving multiple calls from current and potential clients requesting that we provide them with a new policy and procedure manual that covers the new COPs. On the surface, this seems like an easy enough request - for a fee, QIRT... Continue Reading →

Is your Home Care Agency Ready for the Changes Being Implemented in CY 2015?

Each year, many Americans desire change and create annual New Year’s Resolutions, however, this year if you work in the Home Health Industry, resolution or not, change is coming! The first major change in the industry is the process for submission of OASIS documents and the second is OASIS-C metamorphosis into OASIS-C1/ICD-9. CMS has been... Continue Reading →

Responses to 11/10 Scenarios; New Scenarios for 11/17/14

Responses Scenarios for 11/10/14 Question:  How do I code a patient who had a failed skin graft? Answer: There are two codes for rejection or failure of a skin graft.  Code 996.52 is used for a rejection of a natural skin graft and 995.55 is used for dislodgment, displacement, failure, poor incorporation or shearing of an... Continue Reading →

CY 2015 Proposed Rule, how it could affect your agency, and why you NEED to make a comment to CMS…

Point changes, case-mix weight (CMW) changes, and OASIS submission implementation requirements could have a huge monetary impact on your agency.   There is potential to lose millions of dollars in revenue if the proposed rule is implemented as it has been issued. Case-mix weights are continuing on the rebasing train. CMS (Centers for Medicare and Medicaid... Continue Reading →

What does CMS say about Medical Supplies in Home Health?

The law requires all medical supplies (routine and nonroutine) bundled to the agency while the patient is under a home health plan of care. The agency that establishes the episode is the only entity that can bill and receive payment for medical supplies during an episode for a patient under a home health plan of... Continue Reading →

Breaking Medicare Benefits Manual down into bite-sized pieces.

My goal is for each of you to have a working understanding of the Medicare Benefits Manual. I plan on taking parts of the manual and breaking it down into segments. This will enable you have small portions of information to read, which I’ve found is MUCH easier than trying to read a 100-page document... Continue Reading →

CMS announces technical issues affecting home health final claims

The Centers for Medicare and Medicaid Services (CMS) has identified technical issues with parts of the April 2013 quarterly systems release. These issues will affect Home Health claims with dates of service or “through dates” on or after April 1, 2013. As a result, CMS has instructed its Medicare claims administration contractors to hold all... Continue Reading →

New Information required on Home Health PPS Claims

On February 1, 2013, the Centers for Medicare and Medicaid Services (CMS) released a transmittal regarding new information that is required on claim forms. The change requires home health agencies to report new codes indicating the location where services were provided and indicating whether the services were added to the home health plan of care... Continue Reading →

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