About this policy
The goal of this article is to provide a framework for the communication of information that both clinicians and Medicare need to make patient-centered decisions. Services provided by HHAs under the 32x bill type are reimbursed under the Home Health Prospective Payment System (HH PPS), while those delivered under the 34x bill type are reimbursed as Part B Outpatient Rehabilitation Services. Part B Outpatient Rehabilitation Services (with the exception of those furnished by or under arrangements with a hospital) are subject to the financial limitations described in the CMS Internet-Only Manual, Pub. 100-04, Medicare Claims Processing Manual, Chapter 5, Section 10.2. This article underscores the importance of a comprehensive evaluation of the circumstances surrounding the documented fall event(s). It is important that a comprehensive examination and evaluation including a detailed history as well as neurological/sensory, musculoskeletal, and vascular/cardiopulmonary systems reviews be documented. Palmetto GBA is addressing this need through an approach called Going Beyond Diagnosis ® (GBD). GBD promotes use of the International Classification of Functioning Disability and Health (ICF) to capture and organize the information necessary to support the clinical and administrative needs of HHAs performing home-based fall evaluations and interventions.
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
Backwork has no codes on record for this policy. Check the source.