Quality Assurance (QA) review for the OASIS is essential to ensure accuracy, compliance, and optimal reimbursement in home health. However, without the right strategy in place, QA reviews can become time-consuming, inconsistent, and burdensome for clinicians. By implementing best practices, the review process can be… Read More »Best Practices for Efficient OASIS QA Review Program
In home health, accurate diagnosis coding is critical—not only for compliance but also for ensuring agencies receive appropriate reimbursement. Even experienced coders sometimes miss nuances that can impact revenue. Being mindful of these commonly overlooked areas can help capture the full clinical picture and optimize… Read More »Common Coding Mistakes That Can Affect Reimbursements
When a patient returns to Home Health services after an inpatient stay, the OASIS Resumption of Care (ROC) is crucial for ensuring accurate continuity of care and maintaining compliance. Beyond simply updating patient status, the ROC reflects your agency’s quality performance and directly impacts reimbursement. … Read More »8 Key Pointers for Completing an ROC OASIS
The Recertification OASIS is one of the most critical assessments in Home Health—yet it’s also one of the most error-prone. Many clinicians treat it as a simple continuation of care, which often leads to copying prior data, failing to update diagnoses, or overlooking subtle functional… Read More »7 Tips for Completing a Recert OASIS
The Transfer OASIS may be shorter than other timepoints, but it plays a critical role for compliance, continuity of care, and quality reporting. Errors in the Transfer OASIS can cause confusion when the patient returns to home health, distort outcome measures, and raise concerns during… Read More »9 Tips for Completing a Transfer OASIS
For home health coders, the real challenge is not understanding coding rules—it is applying them strategically to balance compliance and reimbursement under PDGM. While primary diagnoses capture the main reason for care, secondary diagnoses play a vital role in reflecting the full clinical picture of… Read More »Coding Secondary Diagnoses and Maximizing Comorbidity Adjustment in Home Health
Accurate wound assessment documentation in home health is essential for effective care planning, regulatory compliance, quality reporting, and proper reimbursement. Wounds represent a significant share of home health cases—affecting about 30% of patients on average, and up to 40–50% in some agencies. Since these cases… Read More »9 Tips for Accurate and Thorough Wound Assessment Documentation in Home Health
As part of the CY 2026 Home Health Proposed Rule, CMS announced the introduction of OASIS-E2—an updated version that includes changes to the assessment items and data collection. To support the rollout, CMS has released the OASIS-E2 Paperwork Reduction Act (PRA) package, which outlines the… Read More »Preview Changes for OASIS-E2 Effective April 2026
The FY 2026 ICD-10-CM update, effective October 1, 2025, includes 487 new codes, 38 revisions, and 28 deletions. Below is a summary of key changes that impact home health coding and their effect on billing: New Code and Additions to the Code Set Revisions and… Read More »[Updated] ICD Code Updates Effective October 1
CMS released its CY 2026 Home Health Proposed Payment Rule on June 30, 2025. The agency projects a 6.4% net reduction in aggregate Medicare payments to home health agencies for 2026—a decrease of approximately $1.135 billion compared to 2025. This net decrease results from several… Read More »Breaking Down the 2026 Home Health Proposed Rule
