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NAHC Report: Issue# 2240, 7/22/2013
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MedLearn Matters Special Edition Advises on Hospice-related Services

Urge Your Senators to Support the “Forty Hours is Full-Time Act”

For Your Information: Deciphering ICD-9-CM Coding for Hospices Webinar Recording Now Available for Purchase
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MedLearn Matters Special Edition Advises on Hospice-related Services

A special edition article from MedLearnMatters was recently released, SE1321. It advises that Recovery Auditors conducted automated claim reviews of medical services provided as separate services, when the Centers for Medicare & Medicaid Services (CMS) regulation or policy, or local practice, dictates that they should have been billed together, rather than individual services for Medicare patients in hospice care. 

The article further alerts providers that they should identify if a beneficiary is enrolled in hospice and document this in the patient’s medical record. The article explains the billing process for items related and not related to the patient’s terminal diagnosis and related conditions for hospice.  It outlines how unrelated claims should be billed. 

The National Association for Home Care & Hospice (NAHC) and its affiliate, the Hospice Association of America (HAA), remind hospice providers to explain to beneficiaries and their families that once a patient has enrolled in hospice, he or she must contact the hospice to arrange for any services needed. If this does not occur and the hospice does not arrange for the care, then the beneficiary may be financially responsible for the expenses. 

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Deciphering ICD-9-CM Coding for Hospices Webinar Recording Now Available for Purchase

“Now we know how to handle coding for our hospice patients who don’t have a specific diagnosis.  Thank you!”

The recording of this popular webinar, presented by nationally recognized ICD-9-CM coding expert Lisa Selman-Holman, is now available in downloadable MP4 and CD-ROM format.   If you previously registered for the event you receive a discount on the recording.  The downloadable MP4 is available for 30 days.  Detailed information about the webinar and presenter are below. 

Order your copy by clicking here.

Webinar Description and Objectives 

CMS has said multiple times that hospices should follow coding guidelines and should be coding more than the one terminal diagnosis. Improved insight into coding guidelines will provide strategies and solutions for compliance with the regulatory mandates from CMS. The timelines for new edits denying primary diagnoses of debility and failure to thrive are unknown but will be announced soon. Educating referring physicians and the operational impact on your monthly claims needs to be analyzed and adjustments implemented now. Lisa will discuss the regulatory mandates and add insight into coding in hospice.

  • Describe how the terminal diagnosis and related diagnoses should be identified.
  • Discuss the CMS decision to prohibit debility and failure to thrive as terminal illnesses and.alternatives to debility and failure to thrive.
  • Identify methods to improve compliance with coding guidelines and describe the patient's complex medical needs related to the terminal diagnosis.

About the Presenter

Lisa Selman Holman, JD, BSN, RN, HCS-D, HCS-O, COS-C
AHIMA Approved ICD-10-CM Trainer/Ambassador

Lisa is a veteran of home care with over 26 years spent in home health and hospice, both as an RN and as an attorney practicing exclusively in home care. She is the owner of Selman-Holman & Associates, LLC, a full-service home care and hospice consulting firm and CoDR (Coding Done Right), an outsourcing company for home care and hospice coding.

She participates on the Board of Medical Specialty Coding and Compliance specialty board on OASIS and is the chair of the specialty board on home care coding. She has provided education to home health and hospice professionals since 1994.

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Urge Your Senators to Support the “Forty Hours is Full-Time Act”

Senator Susan Collins (R-ME) introduced S. 1188, the Forty Hours is Full-Time Act earlier this year. The bill aims to modify certain provisions in the Affordable Care Act (ACA) to define a “full-time employee” as someone who works forty hours a week. The ACA, as it’s currently written, classifies “full-time employees” as anyone who works thirty hours a week or more. S.1188 would allow employees to work more than 30 hours a week without triggering penalties under the ACA on the businesses that hire them. 

The National Association of Home Care & Hospice (NAHC) urges its members to contact their senators and ask them to sponsor the Forty Hours is Full Time Act.

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