Accurate and case-specific coding is vital for success under the Patient-Driven Groupings Model (PDGM). It ensures proper payment and addresses patients’ healthcare needs. Submitting claims with coding errors can result in claim returns and long-term consequences. Agencies consistently submitting invalid… Read More »Coding Reminders and Red Flags
Thorough clinical documentation is crucial for determining eligibility for home health services, ensuring accurate coding assignment, maintaining regulatory compliance, and supporting claims. Incomplete documentation with missing key information can lead to a chain of issues. Beyond knowing the fundamental coding… Read More »Common Documentation Gaps in Specific Code Categories
MACs have reported that one of the top five reasons for claim denial is invalid physician certification, particularly when the necessary face-to-face (F2F) encounter was missing, incomplete, or untimely. To receive payment, SOC certification must include F2F encounter documentation that… Read More »Obtain Complete F2F Documentation with 4 Useful Tips
Coding has become an increasingly important and complex task for home health agencies. There have been recent updates to the guidelines related to the Face-to-Face Encounter and its relevance in primary diagnosis coding, further emphasizing the need for accurate and… Read More »Top FAQs on F2F Encounter Documentation
With the implementation of PDGM, home health coding has become more challenging due to increased documentation requirements and constantly changing guidelines. In addition, agencies must work closely with physicians to ensure complete documentation is obtained to support coding decisions. All… Read More »Coding Best Practices Under PDGM
