Coding

6.2.4 - Coding (Rev. 603, Issued: 07-21-15, Effective: 08-11-15, Implementation: 08-11-15) If the patient’s comprehensive assessment or recertification assessment was signed off and incorporated into the certifying physician’s medical record for the patient (or the acute/post-acute care facility’s medical record if the patient was directly admitted to home health), contractors shall use it to determine whether the Home Health Resource Group (HHRG) codes billed were accurate and appropriate. In addition, if the comprehensive assessment is incorporated into the certifying physician’s record for the patient and is used to support that the patient meets the home health eligibility criteria, then the diagnoses and conditions listed on the start of care assessment must be corroborated by information in the certifying physician’s and/or the acute/post-acute care facility’s own medical record documentation. The contractor shall use the web regrouping program provided by CMS to recode claims as appropriate.