![]() ![]() Without accurate coding, HHAs will not be paid appropriately for the necessary resources to care for patients effectively. It is likely that coding practices will need to change dramatically, both in terms of timing and IDT workflow, as well as training of those responsible for coding. Would it be beneficial to consider outsourcing coding functions?. ![]() Do you have a process in place to engage physicians in obtaining a comprehensive medical history in order to capture all comorbidities?.Have you completed a recent analysis of coding trends? Are a lot of “general” codes being used?.What percentage of your caseload today is being coded into diagnoses that would not qualify for payment under PDGM (RTP)?.What processes are in place to check coding accuracy prior to claim submission and when do they occur?.How are coding changes identified and documented mid-episode?.Do you have access to upstream documentation that can assist with code selection?.Are any external professionals involved in code selection, such as therapy?.At what point during the episode does coding get finalized today?.Are these personnel trained in ICD-10 coding?.Which staff are responsible for ICD-10 coding within your agency?.Get started by reviewing current coding practices and understanding the volume of admissions per month. Given that this is a completely new core competency for HHAs, it is prudent to take action today to assess related risk and begin to identify the changes that will need to occur in order to minimize transition risk. Both timing and accuracy of ICD-10 Coding (primary diagnosis and comorbidities) will play a role in how patients are grouped and, ultimately, reimbursed. One of the most dramatic areas of change relates to ICD-10 coding, which is a significant determinant of revenue in the new paradigm. HHAs will need to completely revise care management and billing processes, as well as documentation and coding practices, in order to make the transition successfully. PDGM implementation is a mere 42 weeks away and is anticipated to be the biggest change in home health payment reform in over 20 years. ![]()
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