Home Health & Hospice Articles by Topic: Medical necessity
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Homecare Direction, Issue 6, June 6, 2019
Strong documentation is key in home health, and implementation of the Patient-Driven Groupings...
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Homecare Q&A, Issue 5, May 31, 2019
You have a specific question about the scope of physician orders and co-signatures.
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Homecare Q&A, Issue 2, February 25, 2019
You say that your agency just learned that according to the revised CoPs, in rehabilitation...
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Homecare Q&A, Issue 2, February 25, 2019
We are assessing and observing if we have an issue related to medical error.
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Homecare Q&A, Issue 1, January 16, 2019
This scenario is not specifically addressed in the OASIS Q&As.
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Homecare Q&A, Issue 17, December 17, 2018
Choose the pre-claim option.
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Homecare Q&A, Issue 17, December 17, 2018
If you feel pretty confident as an agency that your documentation can pass muster and the totality...
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Homecare Q&A, Issue 16, November 20, 2018
All payers must follow the Conditions of Participation, which require an update to the...
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Homecare Q&A, Issue 12, July 25, 2018
We see inappropriate recertifications all over the place.
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Homecare Q&A, Issue 11, July 15, 2018
This question cannot be answered, as each eligibility is established with each particular patient.
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Homecare Q&A, Issue 11, July 15, 2018
First step, ask your biller for the remarks that are submitted by the reviewer at the MAC.
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Homecare Q&A, Issue 10, June 11, 2018
Diagnoses listed in M1011 (Inpatient diagnosis), M1021 (Primary diagnosis) and M1023 (Other...
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Homecare Q&A, Issue 9, May 12, 2018
First off, know on the front end that the biller is looking for those requested records. Ensure...
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Homecare Direction, Issue 1, January 15, 2018
Between the cost of denials and additional staffing expenses to cover the time in-volved in...
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Homecare Q&A, Issue 21, November 2, 2017
MACs use the Fiscal Intermediary Standard System (FISS) to process Medicare Part A claims...
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Homecare Q&A, Issue 19, October 3, 2017
If the agency is not performing any care for the stoma (including any assessment, etc.) then you...
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Homecare Q&A, Issue 14, July 17, 2017
The CoPs make clear that the plan of care will continue to be based on the comprehensive...
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Homecare Q&A, Issue 7, April 4, 2016
In response to this question, CMS has said that it is not necessary to discharge and readmit the...
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Homecare Q&A, Issue 2, January 18, 2016
One of our clients had overlapping visit times. The RN visited, provided skilled nursing care, and...
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Homecare Q&A, Issue 2, January 18, 2016
Thank you for your question and commitment to compliance. Application of the transdermal patch is...
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Homecare E-News, Issue 47, November 30, 2015
The U.S. Department of Health and Human Services released its Agency Financial Report for fiscal...
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Homecare E-News, Issue 47, November 30, 2015
Assisted- and independent-living centers can be attractive places to do business for the home...
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Homecare E-News, Issue 43, November 2, 2015
The written care plan is not simply busywork. It is essential in the organization, delivery...
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Homecare Q&A, Issue 18, September 17, 2015
We have an 87-year-old woman who was referred by the wound care center for care of a wound...
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Homecare Q&A, Issue 17, September 8, 2015
If an agency discharges a patient and that patient resumes services, there may be questions about...
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Homecare Q&A, Issue 15, August 3, 2015
Yes, Medicare will cover two visits if two individuals are needed to perform a covered service...
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Homecare Q&A, Issue 15, August 3, 2015
Medicare doesn’t differentiate between skilled and unskilled personal care because there...
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Homecare Q&A, Issue 15, August 3, 2015
If the patient qualifies for medical social services, the social worker can make one visit if...
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Homecare Q&A, Issue 15, August 3, 2015
Yes, it’s true. Medical social services and home health aide services are considered...
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Homecare Q&A, Issue 15, August 3, 2015
What this agency heard is in error and could lead to denials. Just as with any Medicare-covered...
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Homecare Q&A, Issue 15, August 3, 2015
There are very few times that a clinician will admit a patient and not complete some teaching...
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Homecare Q&A, Issue 15, August 3, 2015
Flushing a peripherally inserted central catheter (PICC) line does indeed require the skills of a...
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Homecare Q&A, Issue 15, August 3, 2015
Changing an ostomy bag, even if the patient can’t do it and there’s no caregiver...
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Homecare Q&A, Issue 15, August 3, 2015
You won’t find any mention in the Medicare coverage criteria about chronic or nonhealing...
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Homecare Q&A, Issue 14, July 16, 2015
According to the final rule for 2015, physicians
must state the length of skilled services
for...
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Homecare Q&A, Issue 13, July 2, 2015
July 3, 2015
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Homecare Q&A, Issue 8, June 9, 2015
First, let’s review for everyone reading what the current CoP is and what is being...
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Homecare Q&A, Issue 0, June 9, 2015
Although the diagnosis and the functional limitations do not stand alone in determining the medical...
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Homecare Q&A, Issue 11, June 3, 2015
If the physician orders vital signs, blood sugar monitoring, and/or pulse oximetry, do we need...
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Homecare Q&A, Issue 11, June 3, 2015
Will you please clarify whether or not it is okay to use a range when defining visit frequency? For...
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Homecare Q&A, Issue 10, May 17, 2015
How are we supposed to use observation and assessment for patients on telemonitoring?
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Homecare Q&A, Issue 10, May 17, 2015
How can extended daily visits be justified and covered?
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Homecare Q&A, Issue 10, May 17, 2015
Can we use “zero” as a frequency in writing physician orders? For example, physical...
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Homecare Q&A, Issue 10, May 17, 2015
Can a single physical therapy visit determine a need for occupational therapy that is covered under...
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Homecare Q&A, Issue 10, May 17, 2015
What are the new therapy reassessment requirements that CMS solidified in its 2015 PPS final rule...
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Homecare Q&A, Issue 9, May 3, 2015
My agency has been reviewing the proposed Conditions of Participation (CoP). We are looking at the...
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Homecare Q&A, Issue 9, May 3, 2015
How do we get paid when we have two different payers—traditional Medicare (Part A) and...
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Homecare Q&A, Issue 9, May 3, 2015
What happens to patients who can self-inject but cannot pre-fill insulin syringes?
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Homecare Q&A, Issue 9, May 3, 2015
When does Medicare consider a wound as chronic/nonhealing and no longer pay for services?
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Homecare Q&A, Issue 9, May 3, 2015
Is it an appropriate use of Medicare to do three weeks of assessment and venipuncture for a patient...
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Homecare Q&A, Issue 9, May 3, 2015
Regarding M0102 and M0104: We received a referral and we contacted the patient within the...
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Homecare Q&A, Issue 7, April 3, 2015
Palmetto and CGS have specific local coverage determinations (LCD) regarding shortand long-term...
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Homecare Q&A, Issue 7, April 3, 2015
You can write orders for when the services begin.
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Homecare Q&A, Issue 6, March 17, 2015
What you are looking for is a nonpunitive, “just” culture for your agency, or a...
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Homecare Q&A, Issue 6, March 17, 2015
In combination, the nurse and HHA can provide up to 35 hours a week in medically necessary...
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Homecare Q&A, Issue 5, March 3, 2015
On the federal level, the CoPs/ Medicare Benefit Policy Manual states that for all certified...
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Homecare Insider, Issue 1, January 5, 2015
Will home health remain exempt from overtime compensation in most circumstances like it has for 40...