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Home Health & Hospice Week

Hospice:

Scrutinize Charges Unrelated To Hospice Terminal Diagnosis -- Before Reviewers Do

Published on Tue May 17, 2011

Use 3 tips to survive the feds' new focus. The cost of caring for your hospice patients may increase under a coming crackdown on Medicare charges unrelated to the terminal diagnosis. Background: Under Medicare regulations, hospices must cover all the Medicare expenses of their patients under their per diem payment, except those unrelated to the terminal diagnosis. At the National Association for Home Care & Hospice's March on Washington conference in March, a Centers for Medicare & Medicaid Services official raised a warning flag about this issue. "A terminal diagnosis is not one ICD-9 code," CMS's Lori Anderson emphasized to conference attendees. At the end of life, "almost everything" is related to the terminal condition. "It's the exception and not the norm if it's not related," Anderson said (see Eli's HCW, Vol. XX, No. 15, p. 115). CMS is seeing cases where hospices classify anything not related to one ICD-9 [...]
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