Archive for August, 2012

August 31, 2012

Medicare cares whether a visit was billable

Question: We have a patient that did not get a face-to-face until after the 30-day mark after SOC.  I know I can go 30 days prior to when the face-to-face took place. When I count back, the patient was seen by a therapist that day but was not seen by a skilled nurse until several days later.  Do I have to have the clinician do an OASIS/485 for the date she saw? The specifics:

HH original SOC 6/29
Face to Face encounter 8/9
Possible new SOC 7/11 (30 days prior to 8/9)
SN saw 7/9, therapy saw 7/11, SN saw 7/20

Do all consent forms need to be redated to new SOC date as well?  New 485, new OASIS?

Lisa says: Your new SOC should be generated based on a date of 7/11 (30 days back from F2F was 7/11). 7/11 is chosen because it is the first eligible date and the first billable visit was made. Medicare doesn’t care who made the visit as long as it was billable.
 
To generate a new SOC assessment, any qualified clinician can sit down with the old SOC and complete the new one based on the same answers with updates to M0110 and M2200. A new 485 will need to completed with updated orders to reflect the 60 days beginning with 7/11 as the “from” date. M0090 will be the actual date that the new SOC is generated so you will receive late warnings.
 
Medicare does not speak to new consents, but I suggest you at least have some kind of communication with the patient in the interest of patient rights. This could get signed at the next visit. For example:

Dear {Patient},

A visit with your physician within a certain time frame when beginning care with a home health agency is a condition of payment for the home health agency. Because you did not see your physician until {date}, we have a new start of care date for you and the care previous to the date is non-covered by Medicare. (You are not responsible for payment.)

We will continue to provide you care under the previous consent forms signed by you or your representative. Please sign this letter to indicate your receipt of this information.

Regards.

Administrator Signature                                                              Patient Signature

August 30, 2012

OASIS expired? No!

The OASIS-C instrument has not expired even though the form contains a July 31, 2012, expiration date. The renewal for the OASIS-C instrument is currently at the Office of Management and Budget. An OASIS-C with a new expiration date will be released once cleared through the renewal process.

We expect M1012 (Procedures) to be deleted as well as changes to the coding data items to allow for ICD-10-CM codes. It is puzzling how CMS intends to re-word the M1020/M1022 item when the codes are no longer V and E codes. Perhaps they will delay that change like they delayed ICD-10!

Want to learn more about OASIS-C? Come to my classes!
Sept 26-27 Oregon Association for Home Care Salem, OR
October 4-5 Home Care Association of Colorado  Denver, CO
November 7-8 Ohio Council for Home Care and Hospice  Columbus, OH

August 24, 2012

ICD-10 delayed one year

The Department of Health and Human Services (HHS) announced Friday the final rule that changes the implementation deadline for the transition to ICD-10-CM and ICD-10-PCS from October 1, 2013 to October 1, 2014.

The rule is scheduled to be published in the Federal Register Sept. 5.
HHS concluded that delaying ICD-10 by one year does the least to disrupt existing implementation efforts, and minimizes the costs of delay, while affording the small provider community an additional year to become compliant. In order to assist entities in being prepared to meet the new compliance date, HHS expects to increase education and outreach events and to work with industry on improvements to the overall standards implementation process.

August 21, 2012

HHQI is back, and we’re part of it


Get ready for quality!

Phase 3 of the Home Health Quality Improvement (HHQI) is about to start with a national campaign launch of Sept. 18.

Selman-Holman Associates is a network coordinator that will lead groups of HHAs in quality improvement movements. We’ll also keep you informed of  HHQI events

More information to come!

August 16, 2012

Open Door Forum transcripts now available

There was a delay on the blog post regarding the recent Medicare Open Door Forums … the post didn’t publish until after the forums had happened!
No problem. Transcripts and audio are now available.

From the August 9, 2012 Medicare Fee-For-Service Recovery Auditor Prepayment Review Demonstration Special Open Door Forum.

From the August 7, 2012 Manual Medical Review of Therapy Claims Special Open Door Forum.