Home Health & Hospice Week

Review denies staggering 92 percent of claims. You'll have to beef up your documentation if you want to protect an at-risk group of claims from expensive Medicare denials. Cahaba GBA reviewed non-start of care claims with a primary diagnosis of Alzheimer's disease and denied 92 percent of claims "based on dollars," the regional home health intermediary says in its December newsletter for providers. The top problem: "The documentation for the skilled nurse visits did not support medical necessity," Cahaba says in the Newsline. "To be covered as skilled nursing services, the services must require the skills of a nurse, and must be reasonable and necessary to the treatment of the patient's illness or injury." Observation and assessment is a covered skilled service, Cahaba allows. But it's covered only if "the likelihood of change in a patient's condition requires a skilled nurse to identify and evaluate the patient's need for possible [...]