AHCC’s advocacy team actively monitors, responds, and participates in industry initiatives to increase the awareness and visibility of the critical role post-acute care plays in the care continuum. AHCC is also committed to setting and measuring standards of professional excellence so patients and their families can have confidence in post-acute care providers.
AHCC and BMSC Respond to Draft Interpretive Guidelines
The Association of Home Care Coding and Compliance (AHCC) together with the Board of Medical Specialty Coding and Compliance (BMSC) submitted comments on the draft interpretive guidelines for the revised Home Health Conditions of Participation (CoPs).
Of special interest to our members, AHCC and BMSC asked for clarification concerning:
- How agencies can demonstrate that transfer and discharge policies of the HHA were provided to patients in “a language they understood and in a manner which accommodated any disability.”
- How a significant change in the patient’s condition will impact the 60 day period for review of subsequent plans of care.
- Whether therapists are permitted to perform the drug regimen review.
To read the AHCC/BMSC comment letter, click here.
AHCC and BMSC Respond to 2018 HHPPS Proposed Rule
The Association of Home Care Coding and Compliance (AHCC) together with the Board of Medical Specialty Coding and Compliance (BMSC) submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the proposed 2018 Home Health Prospective Payment System Rate Update and 2019 Case-Mix Adjustment Methodology Refinements.
Of special concern to our members, the proposed rule outlines plans to:
- Remove the therapy threshold “bonus” payments without factoring in therapy cost calculations elsewhere in the payment system.
- Group home health beneficiaries into six new clinical groups as part of the home health groupings model for payment.
- Return claims that don’t fit into one of the six clinical groups to providers for re-coding.
To read the AHCC/BMSC comment letter, click here
The Home Health and Hospice ICD-10 Transition Workgroup Closing the Coding Guidance Gap
Happy New Year from the Association of Home Care Coding & Compliance (AHCC), a member of the Home Health and Hospice ICD-10 Transition Workgroup - a consortia of associations formed to support agencies as they adapt to the new language, logic and specificity of ICD-10.
October 1, 2015 has come and gone. The sky didn’t fall, but many home health agencies did stumble as they grappled with software glitches, struggled with insufficient documentation from referral partners and from their own clinicians, and with the internal coding-knowledge gaps that surfaced. Agencies also continue to receive conflicting and/or inapplicable guidance from the American Hospital Association’s (AHA) Coding Clinic, CMS’ designee for official ICD coding guidance and clarifications. These inconsistencies can lead to payment delays or claim denials.
The Board of Medical Specialty Coding & Compliance announces the launch of the Home Care Coding Specialist—Hospice (HCS-H) Credential Exam
Gaithersburg, MD – The leading home health and hospice association, The Association of Home Care Coding & Compliance (AHCC) and its credentialing body, the Board of Medical Specialty Coding & Compliance (BMSC), announces the launch of its third home health professional credential, BMSC's Home Care Coding Specialist—Hospice (HCS-H) certification.
The certification exam tests a candidate’s ability to apply knowledge of CMS coding conventions and guidelines related to the use of ICD-10-CM codes in the hospice setting, including proper sequencing of diagnosis codes.
AHCC successfully led effort to resolve 7th character issue with CMS
Gaithersburg, MD 10-29-15 – We spoke, they listened. The Association of Home Care Coding & Compliance (AHCC), a division of DecisionHealth, and its credentialing body, the Board of Medical Coding & Compliance (BMSC), proudly announce that due to its efforts the Prospective Payment System (PPS) Final Rule includes a critical correction.
In its final rule, CMS says it will reissue the PPS payment logic (grouper) to award case-mix points for certain initial encounter codes (seventh character “A” codes), effective Jan. 1, 2016, but retroactive to all claims with a M0090 date on or after Oct. 1, 2015. In determining which diagnosis codes would be appropriate for home health to indicate that care is for an initial encounter, CMS and the cooperating parties developed a revised translation list which will be posted to CMS’ website, although the federal agency did not say when.
Consortia of home health and hospice associations team up with CMS Ombudsman to ease ICD-10 transition
Washington, DC – On Thursday, October 8, 2015 the leading home health and hospice associations and CMS’ ICD-10 ombudsman, Dr. William Rogers, agreed to work together over the next 18-to-24 months to provide support to agencies as they transition to ICD-10.
Members of the workgroup include: Alliance for Home Health Quality and Innovation (AHHQI), Association of Home Care Coding & Compliance (AHCC), National Association of Home Care & Hospice (NAHC), National Hospice and Palliative Care Organizations (NHPCO), and Visiting Nurses Association of America (VNAA).
AHCC and BMSC working to resolve 7th character conundrum
The board members of the Association of Home Care Coding (AHCC) & Compliance and the Board of Medical Specialty Coding & Compliance (BMSC), the credentialing arm, are aware of the 7th character issue and are presently working with CMS to resolve it.
To date, CMS has acknowledged that there is a disconnect between the Coding Clinic guidance and the Grouper Logic and has said that steps are being taken to manage the issue. So far, we’ve heard that claims will be adjusted between October 1 and December 31, 2015, and that the Grouper will be updated on its normal schedule, which would be January 1, 2016.
However, we are still waiting for confirmation from CMS that that is how this problem will be addressed. Rest assured AHCC and BMSC are working on your behalf. A letter detailing our concerns has been drafted and sent to CMS. Click here to review the memo.
If you have further questions about what AHCC and BMSC are doing about this issue, please be on the lookout for updates. Or reach out via email to Megan Gustafson or Corinne Kuypers-Denlinger.
ICD-10 Implementation Success Initiative
As a participant in WEDI/CMS ICD-10 Implementation Success Initiative, AHCC is working collaboratively with other public and private organizations in the health care industry to ensure that the entire industry transitions smoothly from the ICD-9 code set to ICD-10 with minimal impact on productivity and cash flow.
AHCC responds in letter to CMS’ proposed drop of the face-to-face (F2F) narrative requirement
Advocate for the national membership organization for home health coding and compliance professionals, AHCC’s board president, Diana Kornetti, addresses the question – What does the F2F narrative requirement change mean for you and your agency? – and how the PPS Proposed Rule change will affect the home health community.
Kornetti’s comments on the PPS Proposed Rule in a detailed and insightful memo were presented to the CMS on behalf of AHCC members. Click here to review the memo.
Hospital proposed rule: New ICD-10 implementation date is Oct. 1, 2015
Providers can mark Oct. 1, 2015, on their calendars as the date they'll switch to ICD-10, according to a hospital inpatient proposed rule posted April 30.
After Oct. 1, 2015, "we will collect nonelectronic health record-based quality measure data coded only in ICD-10-CM/PCS," the Hospital Inpatient Prospective Payment Systems rule states.
Congress passes one-year ICD-10 delay; Obama signature near certain
Home health agencies are probably looking at an at-least-one year delay in the transition to the ICD-10 code set with the Senate's passage 64-35 of the "doc fix" bill on March 31.
The Protecting Access to Medicare Act of 2014 resets the deadline for implementing ICD-10 until October 1, 2015 —or even later. Section 212 of the bill says that the Secretary of Health and Human Services "may not, prior to October 1, 2015, adopt ICD-10 code sets as the standard for code sets.
WEDI/CMS Welcome Home Health and Hospice to the ICD-10 Implementation Success Initiative
Reston, VA – February 14, 2014
The Workgroup for Electronic Data Interchange (WEDI), a leading authority on the use of Health IT to improve healthcare information exchange, and the Centers for Medicare and Medicaid Services (CMS) welcome the home health and hospice industry to the ICD-10 Implementation Success Initiative. Launched in December, the goal of this initiative is to ensure a successful ICD-10 transition for all health care industry stakeholders including providers, payers, clearinghouses and vendors.