Home Health ICD-9/ICD-10 Alert

Published on Thu Sep 27, 2007 PDF

Keep this 2-page chart in front of you for 2008 coding accuracy.

A case mix code won't always get you case mix points under the final prospective payment system rule for 2008.

The final PPS rule creates 153 case mix groups in place of the current 80. But it's not enough that a diagnosis is on the case mix list. That gives you risk adjustment, but not necessarily payment. To get case mix payment points in the home health resource group, you also have to qualify under the coding line items in Table 2A of the final rule, says consultant and coding specialist Tricia Twombly, BSN, RN, HCS-D, with Foundation Management Services in Denton, TX. Use the table below containing the coding line items to identify what coding variables or coding/OASIS combinations may affect case mix points, she explains.