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Skilled Nursing in Home Health Care

WEBSkilled nursing is the most highly utilized service in home health care. There are many services nursing staff can provide when the beneficiary meets the qualifying …

Actived: 1 days ago

URL: https://www.cgsmedicare.com/hhh/coverage/HH_Coverage_Guidelines/6A.html

Primary Home Health Diagnosis Codes Grouper Update …

WEBThe CY 2023 Final Home Health Clinical Group and Comorbidity Adjustment Diagnosis List provides the clinical grouping of HH diagnosis codes, and all codes …

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J15 HH&H FAQs

WEBThis product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software …

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Home Health Patient-Driven Groupings Model (PDGM)

WEBSE19028 – Payments and Payment Adjustments under the Patient-Driven Groupings Model. Home Health Agency (HHA) Center. Reviewed: 12.08.21. The …

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Home Health Billing Codes

WEBHome Health Billing Codes. The following codes represents that most frequently submitted on home health RAPs/claims. A complete listing of all codes is …

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Physician or Allowed Practitioner Orders, Plan of Care and …

WEBThree basic requirements for ordering services are: The physician or allowed practitioner must be enrolled in Medicare; The ordering National Provider …

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Self-Service Options

WEBSelf-Service Options. The following tools are designed for home health and hospice providers who submit claims to CGS. Disclaimer: CGS' online tools and calculators are …

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Checking Beneficiary Eligibility

WEBChecking Beneficiary Eligibility. To ensure the accuracy and appropriate billing of Medicare covered home health and hospice services, the first vital step is to …

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Annual Wellness Visit (A/B MAC Jurisdiction 15)

WEBFirst annual wellness visit providing personalized prevention plan services means the following services furnished to an eligible beneficiary by a health professional that …

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Home Health Medicare Billing Codes Sheet

WEB38157, 38200. Duplicate billing transaction; adjust or cancel claim or RAP instead of resubmitting. 38107. Re-bill RAP if auto-cancel AND ensure RAP is in P B9997 AND …

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Determining Homebound

WEBThe Centers for Medicare and Medicaid Services (CMS) released a clearer definition of homebound to be used when deciding if patients are eligible for home …

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DOCUMENTATION CHECKLIST TOOL

WEBDo the following data elements match the claim and OASIS assessment: Home health agency (HHA) Certification Number (OASIS item M0010) Beneficiary Medicare Number …

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Standard Companion Guide Health Care Claim Professional …

WEBThis CG also applies to ASC X12N 837P transactions that are being exchanged with Medicare by third parties, such as clearinghouses, billing services or network service …

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Adjustments/Cancels

WEBCancel claims (type of bill XX8) may be necessary when the incorrect provider number was submitted, an incorrect Medicare ID number was submitted, or a …

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FACE-TO-FACE (FTF) Encounters for Home Health Certification

WEBFTF must occur no earlier than 90 days prior to the start of care (SOC) or within 30 days after the SOC. If the FTF encounter occurred within 90 days of the SOC but is not …

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Claims Processing Issues Log

WEBClaims Processing Issues Log. Please reference this page for information about confirmed, system-related claims processing issues before you reach out to the …

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Home Health Medicare Billing Codes Sheet

WEBReport each service as a separate dated line under the appropriate revenue code for each discipline providing the service. You can only report the above 3 G-codes on Type of …

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