Over recent years the Centers for Medicare & Medicaid Services (CMS) has sought to streamline hospice beneficiary eligibility inquiries and establish the HIPAA Eligibility Transaction System (HETS) as the single source for this data. This effort was delayed due in part to the availability of insufficient information in the HETS system regarding hospice benefit period […]
The Centers for Medicare & Medicaid Services (CMS) has released a second set of revisions to Chapter 10 of the Medicare Claims Processing Manual providing instructions to home health agencies for claims submission under PDGM. CMS Transmittal 4294/Change Request (CR) 11272, Home Health (HH) Patient-Driven Groupings Model (PDGM) – Additional Manual Instructions, provides some clarity […]
The Office of Management and Budget (OMB) has approved the Home Health Change of Care (HHCCN) Form, CMS-10280. Effective July 1, 2019, all Home Health Agencies (HHA) will be required to use the renewed form with the expiration date of 4/30/2022 on the bottom. Please note that HHAs may continue to use the old form […]
From October 1, 2018, through April 22, 2019, the home health ordering/referring/attending physician reason code 32072 was not editing correctly. This allowed claims containing a terminated attending physician to incorrectly pay. These claims should have denied. In the beginning of May, a Fiscal Intermediary Shared System (FISS) utility was initiated to adjust claims that should […]