Medicare Compliance with 485 and Orders

[kristy.caldwell]

I would like to know if most agencies write a separate order in addition to the orders that are already on the 485. For an example, on start of care an order to A&E for HH is received, an oasis is completed, a 485 is completed and an additional order with the same information contained within the orders section of the 485 is also written. This means both a 485 and a initial order is sent out to be signed by the physician, this is repeated at recertification as well. Your responses are appreciated. And what is compliant with Medicare guidelines...

[Libby1987]

The *additional separate* order is the verbal auth of the POC made in collaboration with the physician, this covers the care provided in the interim before the 485 is signed and returned.

[Libby1987]

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/bp102c07.pdf

Page 27

secrion 30.2.5

Services which are provided from the beginning of the 60-day episode certificationperiod based on a request for anticipated payment and before the physician signs the planof care are considered to be provided under a plan of care established and approved bythe physician where there is an oral order for the care prior to rendering the serviceswhich is documented in the medical record and where the services are included in asigned plan of care.

[kristy.caldwell]

Thank you so much! This helps. I have always thought the order was necessary but there were a few who thought it wasn't.