Got questions about ICD-10 diagnosis coding for hospice or home health?
Until recently, diagnosis coders had no option but to request official diagnosis coding guidance and clarification from CMS' designated coding gurus at the American Hospital Association's (AHA) "Coding Clinic." But hospice and home health agencies report receiving conflicting and/or inapplicable guidance that could lead to payment delays or claim denials.
"Many times guidance issued by the Coding Clinic is not easily interpreted by or adapted to home health or hospice," explains an email to AHCC members from AHCC Executive Director Corinne Kuypers-Denlinger February 5.
Kuypers-Denlinger gathered other industry associations in an "ICD-10 Transition Workgroup" to work through CMS’ ICD-10 ombudsman, Dr. William Rogers, with Coding Clinic to find a way to prevent official coding guidance from unintentionally leading to improper coding in, or creating barriers to payment for home health or hospice.
The Coding Clinic responded by agreeing to consider the provider's setting when issuing coding guidance. Kuypers-Denlinger's email described this move as "an important step in ensuring that home health and hospice have the tools they need to correctly and compliantly code and submit claims."
The BMSC will review home health and hospice ICD-10 queries. If official guidance is already available, the board will answer the questioner directly. If not, BMSC members will recommend a response and explain the rational to the Coding Clinic, which agrees to consider BMSC-submitted questions and responses before issuing related official ICD-10 coding guidance.
"The BMSC board is comprised of eight of the nation’s leading home health and hospice coding experts," Kuypers-Denlinger's message continues. "Funneling all industry coding questions through one channel and disseminating resulting guidance or clarification throughout the industry at one time," will allow AHCC and BMSC to:
- Identify and resolve widespread coding issues affecting all agencies
- Receive from the Coding Clinic one response that applies to all agencies
- Identify industry-wide knowledge gaps
- Ensure correct and compliant coding based on first-hand knowledge of changing guidance