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Understanding Home Health Prospective Payment System (HH PPS) Case-Mix Refinement Changes
[By Staff Reporters]
A few operational changes were made to the V-Code Table in the updated version of the ICD-9-CM Official Guidelines for Coding and Reporting, including:
- HH PPS grouper software and documentation (effective October 1, 2006): Contains Version 1.06 of the home health PPS case mix grouper software codes, which accommodates changes in OASIS reporting requirements effective 10/1/2006. Also includes the grouper coding logic (pseudo-code), test records, and demonstration programs.
- HH Consolidated Billing Master Code List: An Excel workbook file containing complete lists of all codes ever subject to consolidated billing provision of HH PPS. A master list worksheet shows the dates each code included and excluded from consolidated billing editing on claims, with associated CMS transmittal references. The master list also associates each code with any related predecessor and successor codes. Supplemental worksheets show the list of included codes for each CMS transmittal to date.
Example:
The national unadjusted (wage index) per-visit rate payments paid per code were: [a] home health aide $44.37; [b] medical social service $153.55; [c] occupational therapy $105.44; [d] skilled nursing care $95.79 and [e] speech pathology $113.81.
Assessment
Link: http://www.cms.hhs.gov/homehealthpps/downloads/transitionepisodesqa.pdf
Link: http://www.cms.hhs.gov/HomeHealthPPS/downloads/GuidanceforHHAs_Posting_12-18-2007.pdf
Conclusion
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Filed under: "Doctors Only", Career Development, CMP Program, Health Insurance, Practice Management, Recommended Books | Tagged: CMS, HH Consolidated Billing Master Code List, HH PPS, HIPPS, Home Health Prospective Payment System, ICD-9-CM, medical billing, OASIS, V-codes | 3 Comments »
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