Let's Get Home Health Therapies Right!
Palmetto GBA recently performed several service-specific pre-payment medical reviews on Home Health claims and a number of therapy issues surfaced that led to claim denials.
**PT Hours and Nurse Contact Hours Are Being Offered in NC!!**
Claims were denied or adjusted for the following reasons:
- Information Provided Does Not Support the Medical Necessity for Therapy Services
- Medical Review HIPPS Code Change Due to Partial Denial of Therapy
- Absence of Short and/or Long Term Goals within the Initial (PT/OT/ST as appropriate) Therapy Evaluation Documentation
- The therapy documentation does not support that the Assessment, Measurement and Documentation of Therapy Effectiveness was completed at the required interval(s) and/or was not completed by a therapist.
In this therapy focused webinar, Charles Canaan, BSN, MPH, Palmetto GBA, will address coverage and documentation issues related to the denials and ways your home health therapists can help your agency prevent denials by improving their knowledge of and compliance with coverage and documentation requirements. If you provide therapy, oversee therapy or audit therapy – this webinar is for you!!
The presentation will address:
- Documentation necessary for therapy services to be covered by Medicare Home Health
- Therapy LCDs as an important resource
- Why therapy may be partially denied
- What is necessary for appropriate and compliant therapy goal documentation
- Required intervals for therapy assessment, measurement and documentation of therapy effectiveness
- Coverage of HH therapy benefits when a beneficiary needs skilled care in order to maintain function or to prevent or slow decline or deterioration