LINKS
Regulatory Resources
Medicare PECOS list of enrolled providers. Provided free by CMS. To quickly access the information:
- (1) download the zip file
- (2) open the zip file and save the excel file to a place that you can access the file easily.
- (3)open the excel file with Microsoft Excel.
- (4) Use the "Find" function in Excel and type in the NPI number and select enter. Excel will search the entire list for that NPI number.
- If the number is in the list, it will stop at that entry. Confirm the NPI number and Physician Listed.
- If the number is not on the list, the program will state that the entry has not been found. Double check the NPI number that you have.
HHS Proposes Adoption of ICD-10 Code Sets and Updated Electronic Transaction Standards
Medicare’s list of non-routine supplies and consolidated therapy procedures 2008
Transmittal 220, Change Request 5550 to the RHHIs - CMS sent Transmittal 220, Change Request 5550 to the RHHIs on August 24, 2007, effective date September 3, 2007 with several changes to Publication 100-08 Medicare Program Integrity manual. The change was contained in Section 3.4.1.1 Documentation Specifications for Areas Selected for Prepayment or Postpayment MR, (B) Signature Requirements. The new language eliminates the term “stamped signatures” as a permissible method of physician verification on medical records.
CMS Website Related to Home Health
Medicare Home Health Benefit Policy Manual (HIM-11)
Medicare Hospice Benefit Policy Manual (HIM-21)
State Operations Manual/ Interpretive Guidelines
State of Texas Regulatory Resources
Health and Safety Code Chapter 142
OASIS General
WOCN Clinical Fact Sheets (Updated)
WOCN Statement on Staging Pressure Ulcers (Updated)
OASIS C links
Validation Error Message Guide for OASIS C in zipped format
Best Practices Flow Sheet. The editable version is on our tools page.
Wound Ostomy Continence Nurses Society's Wound Care Guidance
2011 3rd Quarter OASIS Questions and Answers from October 18, 2011
2010 4th Quarter OASIS Questions and Answers from January 19, 2011
2010 3rd Quarter OASIS Questions and Answers from October 19,2010
2010 2nd Quarter OASIS Questions and Answers from July 21,2010
2010 1st Quarter OASIS Questions and Answers from April 21,2010
2009 4th Quarter OASIS Questions and Answers from January 22, 2010
2009 3rd Quarter OASIS Questions and Answers
OASIS C CMS Regulatory Guidance This is the regulatory guidance from CMS. This is a large file.
HHRG Tables effective January 2010
Requirements for Locking OASIS for Submitting RAP
Requirements for Locking OASIS for Submitting RAP2
Coding
ICD-10 Crosswalk Technical FAQs
Case Mix Variable and Scoring Table 4, formerly Table 2a
NRS Scores Table 6, formerly Table 10a
2010-11 ICD-9-CM Official Guidelines for Coding and Reporting
Effective October 1, 2010
2010 ICD-9-CM Official Guidelines for Coding and Reporting
Effective October 1, 2009
Medicare Diagnosis Coding: Change in V Codes
Medlearn on Coding (Not updated and not specific to home health but still helpful)
Board of Medical Specialty Coding
Palmetto LCD/LMRPs on Therapy and Hospice Coverage
NPUAP National Pressure Ulcer Advisory Panel
PPS and Billing
CMS Limitation on Home Health Prospective Payment System (HH PPS) Outlier Payments
Additional Outlier Information from CMS
NUBC Approves Billing/Coding Changes effective July 1, 2010
Tables from Pseudocode - tables from the pseudocode, including Table 4, the list of V codes that have potential underlying case mix codes.
Contingency Plan for NPI Non-Compliance
The Consolidated Billing Master List is attached here.
Medicare Home Health Billing Manual
Medicare Hospice Billing Manual
Palmetto Reason/Remark Code Lookup
National Provider Identifier Information
OBQI Resources
Technical Documentation of OBQI Measure Calculation
Instructions for Using OBQI Measure Calculator
Risk Adjusted Outcome Reports for Each State
Revised Overview of Risk Adjustment Models June 2008
Texas Medical Foundation (QIO)
OBQM/Adverse Events
Other Helpful Websites
National Association for Home Care and Hospice
Texas Association for Home Care