Come to my ICD-10 training in Las Vegas on March 5-6 ..
More details to come!
January 26, 2012
Watch for Palmetto and other probe edits … We can help!
Probe edits are underway from Palmetto with other MACs joining in soon. It is important to follow instructions from your MAC and respond with complete copies of charts.
Selman-Holman & Associates, LLC has been assisting clients with this process for many years and we have been heavily involved in responding to the new round of ADRs and probe edits. Your agency is at greater risk if you 1) have a long length of stay (LOS); 2) have Medicare beneficiaries under the age of 65; and 3) have frequencies of 1w9.
Call us for assistance if you receive a probe notification letter or ADRs. We have an expert team of home health care documentation and coverage experts standing by!
Message from Palmetto:
From: Jurisdiction 11 Home Health and Hospice
Alert: Medical Additional Documentation Requests (ADRs)
Palmetto GBA recently changed the process for mailing medical Additional Documentation Requests (ADRs). Previously, medical ADRs were mailed in yellow envelopes. ADRs are now mailed in white Palmetto GBA envelopes. It is possible that a provider may receive an ADR request prior to receiving their probe notification letter.
If you receive an ADR, it is important that you respond promptly.
January 25, 2012
RAC focus revealed in quarterly newsletter
This recent release by CMS does NOT include home health data, but it does give an idea of what disease systems they see troubles with, as well as what they are looking at in other provider areas.
I’ll link you to the archive of the agency’s quarterly compliance newsletter so you can review all of them, if you like.
January 23, 2012
Learning about diabetes … or not
Some recent studies show that web-based tools are not effective in diabetes management. The good news, however, is that CMS still has brochures and other information to help patients, whether they have diabetes or not, learn about services.
January 19, 2012
Education: Health care transition programs
We all know that health care coordination has been a buzz phrase for a few years. AHRQ recently released some coordination stories. This trend is something we should all keep up on … and take every idea when can get from it.
January 12, 2012
Toenail excision is just that on OASIS
CMS clarified several months ago that toenail removal by a physician is an excision, not a surgical wound. Please answer M1340 accordingly.
December 30, 2011
Gait impairment may impact M1850
CMS has provided some guidance on gait impairment and its potential impact on M1850 …
Question: When completing M1850, Transferring, do I consider the patient’s gait impairment if they must ambulate 12 feet from the bed to get to the closest sitting surface and the need for assistance of another person?
CMS Answer: The need for assistance with gait may impact the M1850, Transferring score if the closest sitting service applicable to the patient’s environment is not next to the bed. M1850 reports the patient’s ability to move from the supine position in bed (or the routine sleeping surface) to a sitting position at the bedside, then some type of standing, stand-pivot, or sliding board transfer to a sitting surface at the bedside. If there is no chair at the bedside, report the ability to transfer from the sleeping surface to whatever sitting surface is applicable to the patient’s environment and need.
If the sleeping surface is in the bedroom and the sitting surface is down the hall in the bathroom and the patient is independent moving from the supine to sitting position, sitting to standing, and then standing to sitting, but requires minimal human assistance or an assistive device to ambulate from the bed to the sitting surface, the appropriate M1850 score would be a “1″. If the patient requires more than minimal assistance or requires both minimal human assistance and an assistive device, the appropriate score would be a “2”.
December 27, 2011
That 5010 transition is when?
I know that no one has forgotten that the Version 5010 transition is this coming week, but I thought I would repost some information from CMS for reference …
The Centers for Medicare & Medicaid Services (CMS) has announced an enforcement discretionary period of 90 days for Version 5010 compliance, the deadline remains January 1, 2012. Enforcement will not be exercised until April 1, 2012; however, it is important that organizations continue to complete the transition to Version 5010 as soon as possible, if they have not done so already.
Version 5010 Resources
CMS is committed to helping organizations make a smooth transition to Version 5010 and ICD-10. The CMS ICD-10 website has been updated to include a new web page dedicated to Version 5010 information and resources. CMS has also posted a new fact sheet, which discusses steps providers should be taking now to ensure a timely transition to Version 5010 by January 1, 2012.
Other materials on Version 5010 include the following fact sheets:
Additional Resources
Stay on top of deadlines and action items for Version 5010 and ICD-10 by referencing the following resources on the CMS ICD-10 website:
- Interactive Widget: A user-friendly tool that outlines the steps to take to ensure compliance with Version 5010 and ICD-10.
- Timelines: Printer-friendly checklists that complement the widget, which are available for large providers , small providers , payers and vendors .
- Implementation Handbooks: Detailed step-by-step guides on how to implement ICD-10, which have been customized for different audiences including small/medium provider practices, large provider practices, small hospitals, and payers.
Keep Up to Date on Version 5010 and ICD-10.
Please visit the CMS ICD-10 website for the latest news and resources, and to download and share the implementation widget today!
December 9, 2011
When would you answer M1730 with NA?
This is part of a recent clarification from CMS on M1730, depression screening.
I don’t understand when I would ever select “NA – Unable to respond” in the PHQ- 2 in M1730, Depression Screening. Please clarify.
CMS Answer: The PHQ-2 is only used for patients that appear to be cognitively and physically able to answer the two included questions. After determining the PHQ-2 is an appropriate tool, the patient may decline or be unable to answer the questions, e.g. patient states the questions are too personal, or the patient may not be able to quantify how many days they have experienced the problems.
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