Last Updated on

Most of you will recall the scare that ran rampant throughout the country with Y2K, well basically the same thing happened with ICD-10 Coding. We were able to get a continuance for one year, but now we are LIVE and full speed ahead with ICD-10 Coding.

The following are several things of interest that you must remember for both Home Health and Hospice:

  • All Local Coverage Determinations (LCD) have been updated with ICD-10 Codes. Make sure that you have downloaded the updated versions and staff members responsible for coding have a copy.
  • Please REMEMBER: there is NO billing edit to verify that diagnosis codes on the Final Claim match the diagnosis codes on the RAP.
  • Due to the specific date requirements and ICD-10, agencies may have ICD-9 codes on OASIS and ICD-10 codes on Plan of Care and Claim. It is acceptable, they are still the same diagnoses, just updated codes. See Chart below for appropriate coding for Home Health OASIS Completion and subsequent claims:

  • Hospice ICD-10 Transition Notes: Important Reminder on Manifestation, Unspecified Codes
    • With October 1 and the transition to ICD-10-CM coding right around the corner, we remind hospices that there remains a prohibition on use of certain diagnosis codes as the principal diagnosis on hospice claims, and we also remind hospices that failure to transition to ICD-10 CM codes at the appropriate time may impact the processing of Notices of Election (NOEs) and Notices of Termination/Revocation (NOTRs). Effective Relative to codes that may not be used as hospice principal diagnosis codes, Attachment A from Change Request (CR) 8877is a list of some of the diagnosis codes in ICD-10 that cannot be used as principal diagnosis codes. In addition to these codes, any manifestation code in ICD-10 cannot be used as the principal diagnosis code on hospice claims. Change Request (CR) 9290 updated the Integrated/Outpatient Code Editor (I/OCE) with a list of manifestation diagnosis codes that would also be unacceptable as a principal diagnosis code for hospice claims. In addition to this list from CR 9290, other manifestation codes can also be found listed on pages 134-137 of the ICD-10 Dx Edit Code List (v15.0 ICD-10 Pilot).
  • As of October 1, 2014, hospices are required to submit NOEs and NOTRs within 5 days following the start of care and termination/revocation dates, and have those notices accepted by the Medicare Administrative Contractor (MAC). The NOE requires the principal diagnosis code. Any NOEs submitted with dates of service on or after October 1, 2015 with an ICD-9 diagnosis code will be returned to provider (T Status). This may result in an untimely NOE and loss of some days of payment for the hospice. Additionally, any NOTR submitted with an ICD-9 code with dates of service on or after October 1, 2015 will also be (T Status).

Remember, while physicians got some relief from the penalties of non-compliance with ICD-10, home health and hospice got NO relief!

Don’t panic, breathe deep and code away!