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 code update, effective October 1, 2025, introduces significant changes with 487 new codes, 38 revisions, and 28 deletions. This October update is part of the biannual ICD-10 updates—one in April and one in October. While April’s changes are often minor or… Read More »Heads Up: 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
Starting July 1, 2025, home health agencies (HHAs) are required to collect and submit OASIS data for all patients regardless of payer, with a few exceptions. Here is a comprehensive guide with key things to remember and next steps to help ensure a smooth transition.… Read More »Getting Ready for July 1: All-Payer OASIS Submission
Lately, there has been a noticeable increase in denials due to invalid Face-to-Face documentation, affecting several home health agencies and raising concerns across the industry. Many of these denials seem to involve cases that came through Community Referrals. Let’s review the F2F requirements and applicable… Read More »New Insights on Face-to-Face Requirements in Home Health
Beginning July 1, 2025, OASIS data collection and submission will be mandatory for all patients regardless of payer, and home health agencies (HHAs) must be equipped to identify which patients are subject to this requirement. In the April 2025 OASIS Q&As, CMS provided several clarifications… Read More »Which Patients are Subject to All-Payer OASIS Data Collection
Effective April 1st, the April 2025 ICD-10-CM updates introduce several important changes that directly affect home health coding. Highlights include new guidance on obesity-related codes, updated documentation requirements for COVID-19, and multiple revisions to the Tabular List of Diseases and Injuries. Here’s a quick look… Read More »April 2025 ICD-10 Updates: What Home Health Agencies Need to Know
With constant changes in home health regulatory requirements, agencies face the ongoing challenge of improving patient outcomes, maintaining compliance, and optimizing reimbursements. To address this, home health agencies must streamline the documentation process at all levels to ensure accurate and thorough documentation of patient assessments… Read More »Key Foundations for Cohesive Home Health Documentation
