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Transitioning to iQIES – Watch Your Final Validation Reports!

In News by Sarah Bacon2 Comments

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 …

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PDGM and My Diagnosis List

In News, OASIS, Online Training, PDGM by Sarah Bacon8 Comments

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 …

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[On Demand Webinar] New Codes, New Guidance, New Guidelines: What you NEED to know for coding year 2020

In News, Online Training by Sarah Bacon17 Comments

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 …

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ROC: The 3 Common Situations

In News by Sarah Bacon2 Comments

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 …

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Breaking News: RCD to begin in Ohio in September

In News by Sarah Bacon1 Comment

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, …

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[On-demand webinar] PDGM and OASIS-D1/Comprehensive Assessment

In News, OASIS by Sarah Bacon12 Comments

On Jan. 1, 2020, “business as usual” will be a thing of the past with OASIS-D1 and PDGM going into effect.  Unlike other providers, home health agencies bill based on clinicians’ documentation. Strong documentation will be the key to accurate coding when identifying the appropriate primary diagnosis to determine the clinical group and all pertinent diagnoses relevant to payment.  Consequently, …

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PDGM: Hysterics of the year 2000 all over again

In News, OASIS by Sarah BaconLeave a Comment

The Patient Driven Grouper Model (PDGM) is the most significant change to the home health payor system since the year 2000. We are moving away from therapy utilization driven payment to a payment largely driven by diagnosis codes.  In this new in-depth course, home health industry expert Lisa Selman-Holman will cover PDGM success tips including: Understanding your percentage of institutional …

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OASIS-D1: What is Your Action Plan?

In News, OASIS by Lisa Selman-HolmanLeave a Comment

It seems Medicare is giving us a “break” when it comes to changes to OASIS in January 2020. A couple of items have been added to the recertification assessment because they are needed for calculating the new functional score–M1800 (Grooming) and M1033 (Risk for Hospitalization).  The biggest change comes from the CMS instruction that MANY items on the recertification will …