2011: Update: New to Homecare? Info to get you started

  1. check out cahaba's:

    coverage guidelines for home health agencies (aug 06 revision)
    94 pages of great advice in easy to read format.

    medicare reference guide: home health coverage guidelines updated link 5/15/2008

    especially helpful is:

    70 conditions the patient must meet (pg. 23)

    70.15 documentation of homebound status (pg.26)

    70.10 beneficiaries who are not homebound (pg. 25+26)

    80.30 prn orders (pg.34)

    80.40 verbal/oral orders (pg.35)

    90 covered skilled nursing services (pg. 38 -40)

    90.5 principle one: requires the skills of a nurse

    90.10 principle two: service is not skilled because performed by a nurse

    90.15 principle three: service does not become unskilled because it is taught

    90.20 principle four: reasonable and necessary

    100 skilled nursing services (pg. 40)

    100.10 management and evaluation of the care plan(pg. 41)

    100.5 observation and assessment (pg. 42)

    110 teaching and training activities (pg. 43)

    110.5 administration of medications (pg. 44)

    110.40 prefilling syringes (pg. 46)

    110.70 catheters (pg. 48)

    110.75 wound care (pg49)

    110.115 diabetes outpatient self-management training (dsmt) (effective 1/1 2004) (pg. 51)

    110.120 foot care (pg. 53)

    110.130 psychiatric nursing (pg. 54)

    140.30 safety dependence/secondary complications (pg. 59)

    150 general principles for reasonable and necessary physical, speech, and occupational therapy (pg. 60)

    200.5 covered home health aide activities (pg. 71)

    210 drugs & biologicals

    drugs and biologicals are generally excluded from coverage under the medicare home health benefit. there are a few exceptions from this exclusion.

    210.5 drugs covered by medicare part b (pg. 73)

    these drugs include hepatitis b vaccine, hemophilia clotting factors, calcitonin, pneumococcal pneumonia vaccine, influenza virus vaccine, and intravenous immune globulin (ivig)

    220 coverage exclusions (pg. 76)

    240.20 blood glucose monitor (pg. 80)

    240.35 protime test systems (pg. 81) * not covered

    240.75 covered medical supplies (pg. 82)

    240.80 routine medical supplies (pg..83) * not covered
    Last edit by NRSKarenRN on May 3, '06 : Reason: edited link
  2. Visit NRSKarenRN profile page

    About NRSKarenRN, BSN, RN Moderator

    Joined: Oct '00; Posts: 27,462; Likes: 13,677
    Utilization Review, prior Intake Mgr Home Care; from PA , US
    Specialty: 40 year(s) of experience in Home Care, Vents, Telemetry, Home infusion


  3. by   renerian
    Excellent! Thanks!

  4. by   NRSKarenRN
    Nurse.com CE articles for those new to HomeCare
    from nursing spectrum/ nurse week ---now nurses.com updated links 4/9/08

    course: 60085 - 5.3 hrs
    getting started in home care
    author: bethany schroeder, ms, mfa, rn

    ce109-60e - 1.0 hr
    [color=#91278e]for nurses new to home care
    authors: terry aisenstein, rn, ma & jennifer savon, rn, ms, chpn
    Last edit by NRSKarenRN on May 15, '13
  5. by   jeepnurse1970
    i desperately need a book like that but searched and searched and couldn't find it. i recently bought springhouse's guidelines for reimbursement/documentation but it was mostly fluff-stuff anyone should already know. i need meat and potatoes!

    anyone know where to find it? bookfinder.com, ebay and amazon didn't have it...sob
  6. by   NRSKarenRN
    Quote from jeepnurse1970
    i need meat and potatoes!
    look at these books by tina m. marrelli--helped me

    [color=#996633]handbook of home health orientation

    diagnosis coding and writing homecare plan of treatments:
    [color=#003399]handbook of home health standards and documentation -- guidelines for reimbursement
    Last edit by NRSKarenRN on Nov 20, '11
  7. by   DutchgirlRN
    Hi Karen, I can't acesss the info in the post. The link is not working?
  8. by   NRSKarenRN
    Fixed the link for you!
  9. by   DutchgirlRN
    Thank you sooooo much!
  10. by   NRSKarenRN
    found today home health quick reference guide supplement -updated 4/08



    [color=#231f20]10 medicare educational resources quick reference guide

    [color=#231f20]40 home health certification and plan of care (poc)

    [color=#231f20]40.5 coding clues[color=#231f20]

    40.5.5 basic icd-9-cm coding
    40.5.10 patient's wound care
    40.5.15 coding for specific diagnoses
    40.5.20 coding a primary diagnosis with therapy services
    40.5.25 coding of chronic conditions in home health

    [color=#231f20]50 wound care flow sheet[color=#231f20]

    [color=#231f20]60 home health quick reference sheets

    [color=#231f20]60.5 home health prospective payment system (hh pps) cheat sheet

    60.10 special billing situations under hh pps
    [color=#231f20]60.15 home health medicare billing codes sheet
    [color=#231f20]60.20 submitting requests for anticipated payment (raps) in msp situations
    [color=#231f20]60.25 home health billing and medicare secondary payer sheet
    [color=#231f20]60.30 hh abn (cms-r-296) regulations and billing procedures
    [color=#231f20]60.35 outpatient home health services reference sheet
    [color=#231f20]60.40 m0175 14 day look-up table

    Last edit by NRSKarenRN on Aug 10, '06
  11. by   NRSKarenRN
    cms--official home health regulations

    chapter 7 - home health services

    above revised 2008 : home health conditions of participation—42 cfr 484.1
    Last edit by NRSKarenRN on Feb 16, '07
  12. by   NRSKarenRN
    What the surveyors are looking for:
  13. by   oktravelnurse
    I've worked in a hospital for about 5 years now. I'm really sick of all the short staffing. I feel like pts and family members can be very demanding but thought if I got into Home Health it might be better....after all I would be meeting them on their turf. Any comments would be appreciated!
  14. by   jkaee
    Quote from nrskarenrn

    thanks karen! i just ordered these books, i want to go over them before i start my ft job as an rn case manager in home health. i'm new to this field, and i'll need all the help i can get. i paid about $70 for both the books (not including shipping) but i think the peace of mind of having some sort of idea as to what i'm facing is well worth the cost.

    thanks again!