tci Medicare Compliance & Reimbursement - 2004 Issue 6

Home Care: HHAs Should Sharpen Their M0175 Skills

CMS backtracks on pledge to clean up HHAs' responses to tricky OASIS item.Back in November, it looked like the Centers for Medicare & Medicaid Services would play fair with M0175. But home health agencies recently found out they could be out $600 per patient if they answer the OASIS item on prior rehab and skilled nursing facility stays incorrectly. "CMS staff and management have reviewed this issue carefully over recent weeks and we have decided that upcoding home health PPS claims in these cases is not the appropriate course of action for the Medicare program," a...

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