Outpatient Outlook: Exceptions Process Lands a 2-Month Grace Period (January 2012)
Hang tight while Congress hammers out a more permanent solution. You can breathe a sigh of relief about therapy caps – but only for a short while. After lots of back and forth between the Senate and the House last December, Congress was finally able to pass a bill that offered a two-month extension of the therapy cap exceptions process in 2012. Details: Signed into law on Dec. 23, 2011, the Temporary Payroll Tax Cut Continuation [...]
Inpatient Insights: 5 Ways to Beef Up Your IRF’s Plans of Care (January 2012)
What you change now will pay off big-time when RAC audits hit.Now that you’ve adjusted to revamped Inpatient Rehab Facility Medicare coverage criteria for the past two years, it’s time to step it up even more. Recovery Audit Contractors (RACs) will be hitting IRFs again, and they’ll play hardball with your documentation. Follow these five steps to ensure rock-solid plans of care that contribute to a steady flow of reimbursement.1. Keep an eye on the [...]
Home Health Therapy: Connect the Dots to Keep Your Therapy Reimbursement Flowing (January 2012)
Make certain therapy-related diagnosis codes are supported by OASIS functional items.The Centers for Medicare & Medicaid Services has therapy in the cross hairs. Make sure you’re doing your part to prevent audit trouble.Keep an Eye on DocumentationWhen it comes to keeping your therapy claims audit-proof, it’s not the diagnosis codes you list that make the difference – it’s the therapist’s documentation. And it’s “your responsibility as a coder to be an advocate with the therapist to [...]
Therapy Documentation: Fix Therapy Documentation Disconnects with 3 Expert Tips (January 2012)
Work together to get documentation in synch.Therapy use continues to garner scrutiny in home health. And it’s the documentation that can sink your claims. Take the time to adjust the way you approach therapy situations to improve patient care and avoid putting your reimbursement in jeopardy.“There is a functional domain disconnect between what the nurse selects on the OASIS and the therapy notes,” says occupational therapist Karen Vance with BKD in Springfield, Mo. “The OASIS [...]
Also: Watch out for this potential problem.Sunshine Terrace Rehabilitation & Skilled Nursing Facility, which used to provide therapy six days a week, has hired two extra therapists so that it can provide therapy services on Sundays, reports Konie Murray, RN, RAC-CT, the MDS coordinator for the facility in Logan, Utah. “I think providing therapy seven days a week helps the patients,” Murray says. However, “some patients will refuse therapy on Sunday and say this is [...]
Industry Notes: PPS Payment Date Dependent on Completion Date (January 2012)
If you’re a home health therapy provider, don’t expect to have an episode’s worth of lag time when switching over to the new prospective payment system case mix grouper. The date you complete the OASIS assessment determines whether you’ll receive this year’s or next year’s PPS payment.The date you enter in M0090 will set whether the 2011 or 2012 PPS grouper applies to your payment, the National Association for Home Care & Hospice points out [...]
Clinical Tip: Figuring Out Why This Resident Wasn’t Participating in Therapy Paid Off (January 2012)
Rather than giving up on providing rehab, the team took a different tack.Pauline Franko, PT, MSCP, recalls a case from many years ago where a SNF patient would feel sick and vomit whenever she attended rehab therapy. But the person wasn’t getting sick at any other time.“The therapist wanted to D/C therapy but we had a psych evaluation and found out that the patient was getting sick because she was afraid of going home,” reports [...]
Part B Questions & Answers (January 2012)
Question: We are a hospital based outpatient therapy department. Can we bill for negative pressure wound therapy under the CPT® code of “97605″ and be reimbursed for this procedure (Medicare)? This would be the only service provided to this patient (wound vac/wound care).Answer: Rick Gawenda, PT, president of Gawenda Seminars & Consulting Inc. responded to this query sent by one of our subscribers by saying, “According to the Centers for Medicare and Medicaid 2012 Physician [...]
Outpatient Outlook: Get Ready: Therapy Caps Exceptions Hang on a String for 2012 (December 2011)
U.S. House and Senate hammering out a last-minute fix.Once again, outpatient therapists face more than their share of holiday stress with a plummeting SGR and therapy cap exceptions expiring in 2012. It’s the same old story every December, with similar last-minute Congressional bailouts, but this year, Congress is drafting some fixes with a different twist.Cross Your Fingers for the House VersionThe House of Representatives recently drafted HR 3606, the Middle Class Tax Relief and Job [...]
Business Strategies: Take Your Marketing to a New Level With Groupon (December 2011)
Plan wisely, or it could do more harm than good.Groupon has hit the country by storm, and it may have a place in your independent therapy practice. Groupon (as well as Living Social) are companies that sell daily email vouchers featuring a local company’s goods or services at a highly discounted rate. Groupon can be a powerful marketing tool but can also put you in a bind if you’re not careful. Follow these tips to [...]
