decisionhealth Newsletters, Part B News - 2001 Issue 2 (February)
Recertification of home health patients must be more than just cursory exam
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Article Overview
This article is for physicians, home health providers, and medical coders who need to understand Medicare billing and documentation expectations for home health certification and recertification services. It summarizes the policy context surrounding new HCPCS codes, discusses the level of review and documentation emphasized by agency representatives, and notes the limited billing guidance available from HCFA and carriers at the time.
Why This Topic Matters
Home health certification and recertification services affect Medicare reimbursement and require documentation that supports the physician’s involvement. The article highlights why payers may scrutinize these claims and why providers should understand the published guidance and current carrier expectations.
What You Will Learn
- The Medicare policy context for physician certification and recertification of home health plans of care
- What types of documentation and record review are discussed in relation to these services
- How HCFA and carrier representatives were describing available billing guidance
- Why providers were advised to monitor payer responses to these home health claims
Who Should Read This
- Physicians
- Home health agencies
- Medical coders
- Billing staff
- Compliance staff
Codes Discussed
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