Every October, many changes go into effect for Home Health and Hospice agencies. On October 1, changes that were related to the Hospice Final Rule went into effect, including all changes to payment and reimbursement which includes an increase of 3.8%. 

Any of the other regulatory changes, including the maximum of a 5% decrease year over year in any agency’s wage index, as a result of an agency being moved from urban to rural in CBSA classification will be in effect. 

Effective October 1, the new ICD-10 changes will be implemented for both Home Health and Hospice. Many ICD-10 changes were addressed in our free coding webinar which was facilitated by Melinda Gaboury, CEO and Robbie James, Director of Coding and OASIS Review. 

In addition to the changes that will go into effect October 1, be sure to remember that the January 1, 2023 implementation of the Home Health rule does include changes to the diagnosis codes that pertain to the calculation of the PDGM calculated HIPPS code for payment.  While there will be new diagnoses added to the list of acceptable primary diagnoses for PDGM, the changes that come with the reclassification of secondary diagnosis categories for the low and high comorbidity adjustment are the most significant. 

It is imperative that your coding staff be fully prepared for both the new ICD-10 changes that went into effect October 1, as well as the changes that have been proposed to the PDGM model for January 1. 

Understand that with the PDGM changes that will go into effect for Home Health, there will be changes to the LUPA Thresholds that coincide to the case mix groups.  Pay attention to the coding changes that are going to happen that will impact the primary diagnosis decision, as well as the low and high comorbidity adjustment, which are a part of the case mix calculation driving the HIPPS code for reimbursement and LUPA Threshold establishment.  

If there is anything that Healthcare Provider Solutions can do to help you, please do not hesitate to let us know.

We encourage you to register for the National Association for Home Care and Hospice Annual Conference that will be held this year in Saint Louis, October 23rd – 25th as the educational opportunities are endless.