3 home health care coding habits that can hurt your agency

Your agency relies on accurate, efficient home health care coding for timely, accurate reimbursement. Many agencies suffer from a few common coding issues that can seriously hurt them. And with ICD-10, many coders have found themselves overwhelmed, relying on techniques to ward off productivity problems, often at the expense of accuracy. Here is a list of common home health care coding habits that your agency should avoid.

Home Health Care Coding Habit #1: Failure to Use Resources

Under the new Home Health CoPs, CMS is looking for documentation that supports the unique story of each patient. However, after a short time, coders begin to memorize basic codes and use them on a frequent basis.  Falling into a routine of coding strictly from memory is a bad habit.

Although coders may see the same diagnoses and similar care plans each day, if one patient has something a little different, coding needs to reflect the difference. Otherwise, you could have serious problems. First, you may not receive the maximum reimbursement allowed, which negatively impacts your ability to grow your agency and best serve your clients. Secondly, you may be improperly reporting patient outcomes. With outcomes being publicly reported on Home Health Compare, you may be losing out on referrals and new admissions.  Lastly, carbon copy patient charts are a red flag for CMS and may lead to an audit. Therefore, it’s important that home health coders have access to current resources. They should be continuously trained on the latest regulations and requirements.

Home Health Care Coding Habit #2: Utilizing Home Health Care Coding “Cheat Sheets”

Second on our list of home health care coding habits is the use of coding “cheat sheets.” These are often created to help coders assign diagnoses more quickly. However, these unofficial resources may lack the specificity to make a correct diagnosis. They also may not be updated regularly to reflect current regulations or code changes. While it’s good to have resources at their fingertips, coders shouldn’t completely rely on cheat sheets. Remember…regulations change, and patients are all unique. It’s vital that coding is done specifically for each individual patient so nothing is missed and mistakes aren’t made.

Home Health Care Coding Habit #3: Succumbing to Quota Pressure

The last of the home health care coding habits is allowing coders to succumb to quota pressure. If a coder is faced with mounting quota deadlines, s/he may spend less time reviewing documentation properly. S/he may also forego using official resources to allocate codes. When coders are overwhelmed, the likelihood of errors increases. Therefore, coders need time to review documentation to determine the correct diagnosis codes. If your agency is experiencing a high volume of errors or running on a consistent backlog, you should consider working with a third party home health coding provider to support your team. This can be a great solution to help manage a high volume of claims or some of your tougher ones.

In conclusion, it’s important to catch unsatisfactory home health care coding habits sooner rather than later. As a leader, you can support your team by addressing systemic problems at the root of the cause, help them understand areas needing assistance, and offer solutions. Oftentimes, you can spot these habits through quality chart reviews. By training coders to avoid some of these home health coding bad habits, it’s easy to prevent problematic coding habits before they have a chance to form.