Home Health Coding

Course Outline

 

 

        I.      ICD-9-CM Diagnostic Coding for Home Health

a.            Infectious and Parasitic Diseases

b.            Neoplasms

c.            Endocrine, Nutritional and Metabolic Diseases, and Immunity Disorders

d.            Diseases of the Blood and Blood-Forming Organs

e.            Mental Disorders

f.              Diseases of the Nervous System and Sense Organs

g.            Diseases of the Circulatory System – Coding CVAs per CMS Guidelines

h.            Diseases of the Respiratory System

i.              Diseases of the Digestive System

j.               Diseases of the Genitourinary System

k.            Diseases of the Skin and Subcutaneous Tissue

l.               Diseases of the Musculoskeletal System and Connective Tissue

m.          Congenital Anomalies

n.            Symptoms, Signs, and Ill-Defined Conditions

o.            Injury and Poisoning

p.            Supplementary Classifications – Aftercare V-codes/Other commonly used V-codes/Therapy/Drug Monitoring/Poisoning/Adverse Effects

 

II. Case Mix Methodology:

a.      Request for Anticipated Payment (RAP)

b.      Episode of Care payment divisions

c.      Case Mix Groups

·        Orthopedic

·        Neuropathy

·        Diabetes Mellitus

·        Burns/Trauma

 

III.  Home Health Resource Group (HHRG) Case Mix

a.      Background

b.      Low Utilization Payment Adjustment (LUPA)

c.      HHRG Scoring

 

IV. Coding Compliance

a.            Principal Diagnosis (M0230)

b.            Secondary Diagnosis ((M0240) and other DX

c.            Case Mix Diagnosis/Payment Diagnosis (M0245)

d.            Manifestations Codes and Sequencing

e.            Coding Accuracy

 

 

V. Knowledge Application on Case Scenerios

 

VI.  Appendices

a.       ICD-9-CM Official Coding Guidelines & How they relate to Home Health Dx coding

b.      Outcome and Assessment Information Set (OASIS) form

c.      Home Health Plan of Care (CMS-485)