Hospices continue to have trouble billing claims correctly after the switch to Core-Based Statis-tical Areas (CBSAs) from Metropolitan Statistical Areas (MSAs) Oct. 1 (see Eli's HCW, Vol. XIV, No. 36).
Hospices can find their CBSA codes in the Tables section of the 2006 Hospice Wage Index final rule at
www.cms.hhs.gov/providerupdate/regs/CMS1286F.pdf, RHHI United Government Services reminds hospices on its Web site.
"When reviewing Table A, if your city on the list of Urban Areas has an asterisk (*) under it, you will need to review Table C for your designated CBSA Code," UGS warns.
Ignore error messages: UGS is also aware of a problem when hospices enter Notices of Election into the Direct Data Entry system, the RHHI says in another posting. Even though an error message generates when you enter an NOE, "the NOE is processing, so the NOEs do not need to be entered again," UGS instructs. "If you need to verify that the NOE went through, you can check the Claims Summary screen in DDE."
At RHHI Palmetto GBA, hospice claims were incorrectly suspending to status/location SB 0100 due to a change in the system edit order, the intermediary explains on its Web site.
The Fiscal Intermediary Shared System "has established Reason Code 37402 to take the place of Reason Code 38146 for claims with the receipt date of 10/01/05 or later," Palmetto says on its Web site. But "if the prior claim has not processed, then the current claim will Return to Provider (RTP) with Reason Code 37402," the intermediary cautions. • Physicians will see their Medicare payment rates for home health and hospice certification and care plan oversight go down starting Jan. 1--unless Congress takes action.
The average rate before geographic adjustment for home health certification (G0180) will be $70.91 in 2006, down from an average of $74.28 in 2005, reports the National Association for Home Care & Hospice. The 2006 rate for home health recertification (G0179) is $54.27, home health care plan oversight (G0181) is $118.66, and hospice CPO (G0182) is $125.53, according to NAHC. A new service allowed for physicians, hospice evaluation (G0337), will have a Medicare payment rate of $70.18. • The DME industry is working to build support for the Hobson-Tanner bill modifying competitive bidding. The American Association for Homecare's State Leaders Council gathered at Medtrade in Atlanta to discuss ideas, which included identifying providers in each congressional district who could act as effective advocates. The group is also planning to assemble a list of best practices to be shared among the state associations.
Advocacy materials are available at
www.aahomecare.org under "Advocacy Priorities." • Almost Family Inc.'s profits have soared in the quarter ended in September, thanks to the sale of its adult day [...]
