Here are 5 new supply codes you're financially responsible for.
Home health agencies will say hello to five new supplies codes and goodbye to three old ones on the home health consolidated billing list.
HHAs are responsible for payment of supplies and services on the list when patients are under a home health plan of care. "New updates are required by changes to the coding system, not because the services subject to HH consolidated billing are being redefined," the Centers for Medicare & Medicaid Services maintains in an Oct. 14 transmittal (CR 4114).
Starting Jan. 1, CMS will add to the bundling list HCPCS codes A6457 (Tubular dressing with or without elastic, any width, per linear yard), A4412 (Ostomy pouch, drainable, high output, for use on a barrier with flange [2 piece system], without filter, each), A5120 (Skin barrier, wipes or swabs, each), A4363 (Ostomy clamp, any type, replacement only, each), and A4411 (Ostomy skin barrier, solid 4x4 or equivalent, extended wear, with built-in convexity, each).
Code A5120 replaces code A5119 (Skin barrier wipes box pr), a revised definition of A4215 replaces code A4656 (Needle, any size each) and code A6025 (Gel sheet for dermal or epidermal application [e.g. silicone, hydrogel, other]) will be deleted altogether, CMS says.
There are no therapy updates this time around, CMS adds. An updated home health consolidated billing master code list is at
www.cms.hhs.gov/providers/hhapps/default.asp (scroll to bottom of page). • A recent federal report on inhalation drug services is coming under fire from the industry. Commenting on the HHS Office of Inspector General's report questioning the need for the service fee, Apria Healthcare Inc. CEO Lawrence Higby said he was "extremely disappointed that the OIG disregarded or excluded most of the services necessary to safely and effectively provide home inhalation therapy, before reaching the conclusion that inhalation patients do not receive meaningful services."
The Lake Forest, CA-based company--which recently announced a downturn in revenues from its respiratory line--estimates the OIG excluded services that represent over 80 percent of the total costs incurred providing such services. • HHAs struggling with OASIS accuracy can find help in the updated version of the 3M National OASIS Integrity Project Report.
The update to the 2003 report includes new techniques and questions to improve agencies' accuracy when responding to the OASIS M0 items, according to Robert Fazzi, president of Northampton, MA-based Fazzi Associates.
The new version takes into account the updates to the OASIS Question and Answers that CMS added to its Web site in June.
The report is available at no charge through the National Association for Home Care & Hospice at
www.nahc.org/NAHC/CaringComm/eNAHCReport/datacharts/oasisreport2005.pdf. For more information on OASIS, see Eli's OASIS Alert at
www.elihealthcare.com/spec_oasis.htm or by calling 1-800-874-9180.
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