After two years under the “new” Conditions of Participation, I’ve had a question that has come up several times in the last few weeks, so thought I’d share: If a patient dies while under the care of the home health agency, do we have to complete a Discharge Summary? Researching the CoPs and Interpretive Guidelines: Everything in the CoPs and …
[Live Webinar] Wounds and the Wound Grouper
Some wounds are easy. You code the wound and the patient is in the wound grouper. It’s not so easy when conventions and other rules get in the way OR CMS did not place the wound in the grouper. How does the agency get compensated for the wound in this case? CMS has provided guidance and Lisa has developed a …
Update at the 30-Day Time Point
Do we have to make changes at the 30-Day time point? Yes! The Claims Processing Manual states that “each claim must represent the actual utilization over the period.” So if the focus of care for the first 30 days is resolved by day 28, you must update the diagnosis list for the second 30 day payment period to reflect the …
Transitioning to iQIES – Watch Your Final Validation Reports!
The clock is ticking loudly!! Home Health Agencies (HHAs) are transitioning to iQIES (Internet Quality Improvement and Evaluation System) on January 1, 2020. You’ve been transmitting your OASIS data sets to CMS via the QIES ASAP (Quality Improvement and Evaluation System – Assessment Submission and Processing) system since submission was required – many years! By now, your agency should have …
PDGM and My Diagnosis List
A question that we all have pondered at some time over the last few months…How are those diagnoses going to get on that claim? What do they mean when they say the diagnoses don’t come from the OASIS? What if a new diagnosis is communicated to us in the middle of a 30-day period and a new OASIS is not …
[On Demand Webinar] New Codes, New Guidance, New Guidelines: What you NEED to know for coding year 2020
Join Lisa Selman-Holman for a webinar where she will discuss the changes slated for October 1, including new codes, guidelines, and Coding Clinic guidance pertinent to home care and hospice. Confused about “with” and its impact on your coding? Heard the latest on diabetic PVD and venous stasis? What do you code when the patient has an ulcer and has …
[Free webinar series] PDPM coding for skilled nursing: Avoid these common traps
Diagnosis coding accuracy is extremely important for PDPM success. Coding problems are the same no matter the setting. In this three-part webinar series, well-known coding expert Lisa Selman-Holman will cover the most common ICD-10 coding mistakes: Fractures Symptom coding and the ‘with’ convention Diabetes and hypertension coding Lisa will teach the guidelines with real-life examples, so you can be on the …
ROC: The 3 Common Situations
A Resumption of Care (ROC) assessment is required any time the patient is admitted as an inpatient for 24 hours or more for other than diagnostic tests. It always follows a transfer. There are 3 common situations with a ROC: 1. The 1st is when the agency knows the patient was in the inpatient facility and knows when …
Breaking News: RCD to begin in Ohio in September
CMS has just announced that the Review Choice Demonstration (RCD) will begin in Ohio on September 30, 2019. The choice selection period will be August 16 – September 15. Please see the CMS announcement below for more additional details about this as well as the CMS statement that it anticipates 60-90 days between beginning the demonstration in the remaining states of Texas, …