CMS Issues Instructions For Medical Review On Home Health Certifications

Posted on Wednesday, July 22, 2015 2:08 PM

CMS has released Transmittal 602, Change Request (CR) 9189, which provides medical review instructions on the certification and recertification requirements for home health services. CR 9189 instructs reviewers that the physician’s entire medical record should be reviewed to determine if the eligibility criteria for home health services have been met. The physician’s record must include information that supports all the required elements for certification, including the need for skilled service, reason for homebound, and a valid face-to-face (F2F) encounter. Additionally, any documentation from the HHA that is incorporated into the physician’s record must corroborate the physician’s medical record for the patient and be “signed off” by the physician in a timely manner. Click here to see the CR. Click here to read more.

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