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)