Below is a repost of a Briggs post written by Mary Madison, RN, RAC-CT, CDP, Clinical Consultant, Briggs Healthcare. CDC updated the following COVID-19 guidance during the 1st two (2) weeks of June: Using Telehealth to Expand Access to Essential Health Services during the COVID-19 Pandemic How to Wear Cloth Face Coverings Updated Clinical Questions about COVID-19: Questions and Answers NHSN LTCF Guide to Using …
Selecting (and defending) the primary diagnosis
Getting the right primary diagnosis can be a real challenge, and generate some lively debate among clinicians, QA managers and coders. Ultimately, we must meet the requirements for payment under the Medicare coverage and payment regulations. The primary diagnosis must be supported by documentation in three places The Face-to-Face encounter note from the physician or non-physician provider The problem(s) identified …
BREAKING NEWS: Nursing Home COVID-19 Data and Inspections Results Available on Nursing Home Compare
Below is a repost of a Briggs article written by Mary Madison, RN, RAC-CT, CDP, Clinical Consultant, Briggs Healthcare. “Today, the Centers for Medicare & Medicaid Services (CMS) is posting the first set of underlying coronavirus disease 2019 (COVID-19) nursing home data. On April 19, 2020, CMS announced the requirement that nursing homes to inform residents, their families, and their representatives of COVID-19 cases …
Medicare temporarily expands coverage of telehealth services
Telehealth is a visit with a provider that uses telecommunication systems between a provider and a patient. Medicare has temporarily expanded its coverage of telehealth services by waiving 42 CFR § 484.55(a), allowing home health agencies to perform the initial assessment remotely. The initial assessment must still be provided within 48 hours of the patient’s referral or return home …
AMDA Considerations to Consider Before Implementing Universal Testing
Below is a repost of a Briggs article written by Mary Madison, RN, RAC-CT, CDP, Clinical Consultant, Briggs Healthcare. AMDA posted this document on May 18, 2020. Here is the issue that the document addresses: “There is a clear understanding that protecting our vulnerable post-acute and long-term care (PALTC) population is dependent on adequate access to testing. Testing must be readily accessible, completed in a timely …
YES! COVID-19 can be coded based on a positive lab result
Lots of folks are making statements about physician documentation linking positive test results and not being able to code based on lab results. When coding COVID-19, there are exceptions in both cases. COVID 19 guidelines Code only confirmed cases. Code only a confirmed diagnosis of the 2019 novel coronavirus disease (COVID-19) as documented by the provider, documentation of a positive …
CARES Act Provider Relief Fund
Attention home health agencies and hospices! If you see an unexpected Medicare payment from CMS this week deposited in your bank as “HHSPAYMENT”, don’t be alarmed, as these payments are not billing errors. These payments are part of the CARES ACT relief fund to help providers maintain stability during the COVID-19 crisis. CMS is sending $30 billion to all Medicare-reimbursed …
Initial Visit and SOC Comprehensive Assessment – not the same thing!
Due to the COVID-19 Public Health Emergency(PHE), CMS has waived the Home Health Condition of Participation under 42 CFR § 484.55(a) regarding the initial assessment: This change allows home health agencies to perform initial assessments and determine patients’ homebound status remotely or by record review. However, the initial assessment visit is NOT the same as the Start of Care comprehensive …
CLARITY for Home Health Agencies
Annette Lee, RN, MS, COS-C from Provider Insights, Inc. has provided more clarity for home health agencies during this time. Read the full summary below. So, last night, CMS published a “Fact Sheet” of additional blanket waivers and flexibilities provided to the home health industry. Immediately, we all heard different interpretations. Today, like many of us, I spent the day reading the …
Interim Final Rule on Telehealth in Home Health CMS-1744-IFC
The HH PPS provides payment for all services furnished under the Medicare home health benefit as outlined in section 1861(m) of the Act in the form of a “bundled” 30-day unit of payment that is adjusted for case-mix and area wage differences in accordance with section 1895(b) of the Act. Section 1895(e)(1)(A) of the Act states that nothing under section …