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:: NAHC Report
NAHC Report: Issue# 2248, 8/5/2013
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ARTICLE ARCHIVES MEMBER RESOURCES eNEWSLETTERS CARING STORE
Hospice FY2014 Payment, Wage Index Final Rule Issued: Debility, AFTT Prohibited as Principal Diagnoses Starting October 1, 2014 (Part One)
Hospice FY2014 Payment, Wage Index Final Rule Issued: Debility, AFTT Prohibited as Principal Diagnoses Starting October 1, 2014 (Part Two)
For Your Information: Deciphering ICD-9-CM Coding for Hospices Webinar Recording Now Available for Purchase
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CMS Issues Change Request for Demand Billing of Hospice General Inpatient Level of Care

On August 2, the Centers for Medicare & Medicaid Services (CMS) issued a final rule: Medicare Program; FY2014 Hospice Wage Index and Payment Rate Update; Hospice Quality Reporting Requirements; and Updates on Payment Reform.  The final rule is scheduled for publication in the Federal Register on August 7, 2013. 

FY2014 wage index tables are available in the downloads section of CMS’ website.

The final rule addresses:

  • Updates to hospice payment rates and wage index effective for fiscal year (FY) 2014.  Hospices will net an update of 1.0 percent after taking into account Affordable Care Act reductions and changes to the wage index - including the fifth year of the phase-out of the budget neutrality adjustment factor
  • A number of issues related to diagnosis reporting on hospice claims, including:
    • Further expresses CMS’ expectation that hospices will include a principal diagnosis and all related coexisting diagnoses on claims
    • Clarifies CMS’ intent to return to provider (RTP), effective for claims submitted on or after Oct. 1, 2014, hospice claims with either Debility or Adult Failure to Thrive (AFTT) listed as the principal diagnosis
    • Cautions hospices that a number of diagnoses for “dementia” are inappropriate for use as principal diagnoses on hospice claims
  • For the hospice quality reporting program (HQRP):
    • Confirms CMS’ intent to eliminate collection of the structural measure and NQF0209 at the end of calendar year 2013
    • Finalizes CMS’ plans to begin collection of the Hospice Item Set (HIS) starting in July 2014
    • Indicates that CMS will begin collection of data related to the Hospice Experience of Care Survey beginning January 1, 2015, and,
  • Provides an update on hospice payment reform

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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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Hospice FY2014 Payment, Wage Index Final Rule Issued: Debility, AFTT Prohibited as Principal Diagnoses Starting October 1, 2014 (Part Two)

As part of the Final Rule, CMS provided an update on the Hospice Quality Reporting Program (HQRP) and some details of two components of the HQRP:  (1) the Hospice Item Set (HIS) and (2) the Hospice Experience of Care Survey. 

Hospices were mandated to participate in reporting of two quality measures at the beginning of 2013 – the structural measure and the pain measure (NQF #0209).  The reporting deadlines were January 31, 2013 and April 1, 2013, respectively.  Hospices not meeting the January 31, 2013 structural measure reporting deadline and/or the April 1, 2013 pain measure reporting deadline are scheduled to have their market basket update reduced by 2 percent for FY2014. 

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