How Coding Could Change Under the Home Health Proposed Payment Rule

Sunday, August 28, 2022

While home health providers wait for the proposed payment rate rule, it’s important to get familiar with the coding changes the proposal makes, and how it will directly impact Patient-Driven Groupings Model (PDGM) calculations.

When coding, the primary diagnosis of the patient should be driven by the primary focus of care for that time period.

“When you’re initially coding a brand-new start of care for a patient, or a recertification of a patient, you’re obviously going to be coding the primary focus that is the intent for that 60-day episode,” Melinda Gaboury said during a webinar hosted by the company on Tuesday. “That, of course, is for the plan of care and initially for the start of care OASIS.”

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