The document discusses common ICD-9 coding errors made by home health agencies that can significantly reduce revenues. These include failing to account for a patient's status in the past 30 days, leaving diagnoses unspecified rather than providing specific details, and ignoring specific diagnosis codes. Outsourcing coding to certified professionals can help agencies avoid these errors, improve cash flow by increasing accurate billing and payments, and prepare for the upcoming ICD-10 transition.
ICD-9 Coding Errors That Are Costing Your Home Health Agency
1. ICD-‐9
Coding
Errors
That
Are
Costing
Your
Home
Health
Agency
While
the
conversion
to
ICD-‐10
has
been
postponed
to
October
2015,
many
home
health
agencies
are
still
making
ICD-‐9
coding
errors
that
can
be
extremely
costly
(if
not
devastating)
to
their
bottom
line.
Codes
are
complicated
and
even
a
minor
coding
error
can
result
in
billing
rejections,
delays,
and/or
decreased
revenues.
When
you
add
these
simple
errors
to
not
providing
the
required
details
regarding
a
specific
diagnosis,
the
lack
of
reimbursements
can
cripple
your
agency
and
even
put
you
out
of
business.
What
follows
are
just
a
few
of
the
common
ICD-‐9
coding
errors
we
see
on
a
regular
basis—
errors
that
unnecessarily
reduce
home
health
agencies’
precious
cash
flow
and
critical
income.
With
your
financial
future
hanging
in
the
balance,
you’ll
want
to
avoid
these
mistakes
that
can
make
or
break
your
agency.
Accounting
For
the
Last
30
Days
Most
home
health
agencies
review
their
files
before
billing
but,
when
billing,
they
do
not
account
for
the
past
thirty
days.
For
example,
for
patients
who
have
extended
care
in
the
last
2. thirty
days,
the
assessment
documentation
may
not
reflect
current
acuity
or
decline
in
functional
status
of
the
client
because
the
clinician
has
relied
on
the
patient’s
self-‐report.
Without
accurate
reflection
of
current
status
you
will
have
difficult
time
reflecting
improvement
by
the
time
you
discharge
and/or
the
care
is
medically
necessary.
Leaving
Debility
Unspecified
The
current
status
of
the
patient
is
imperative
for
ICD-‐9
coding.
Medicare
and
other
payers
need
to
know
the
current
status
of
the
patient
before
accepting
any
new
billing.
If
you
cannot
identify
the
root
cause
of
why
a
patient
is
receiving
care
or
the
cause
of
his
current
decline,
you
may
find
more
rejections
with
Medicare
and
other
insurance
companies.
Ignoring
Specific
Diagnosis
Even
if
you
can
define
the
debility
or
specify
to
payers
how
a
client
became
debilitated,
you
also
need
to
offer
a
specific
diagnosis.
For
example,
if
you
have
a
client
listed
in
a
broad
category
such
as
heart
disease,
you
are
not
being
specific
enough
for
insurance
companies
and
other
payers.
The
more
specific
you
can
be
when
defining
a
patient’s
diagnosis,
the
more
accurately
you
can
report
the
reasons
why
the
services
were
provided.
ICD-‐9
coding
errors
in
this
area
are
extremely
costly,
resulting
in
lost
or
delayed
reimbursements.
When
you
implement
the
right
billing
practices
and
are
not
only
accurate,
but
also
as
definitive
as
possible,
you
drastically
improve
your
cash
flow
and
ability
to
effectively
run
your
agency.
For
some
home
health
agencies,
having
the
right
billing
practices
means
hiring
their
own
certified
coders
or
outsourcing
ICD-‐9
coding
to
a
home
health
consultant
with
certified
coders.
Hiring
these
highly
trained
professionals
ensures
that
you
remarkably
reduce
if
not
eliminate
the
possibility
of
ICD-‐9
coding
errors,
which
leads
to
improved
revenue
per
case
and
increased
cash
flow.
It
all
adds
up
when
you
consider
that
the
difference
between
valid
and
inadequate
codes
can
amount
to
hundreds
of
dollars
per
episode.
The
Easiest
Way
to
Prevent
ICD-‐9
Coding
Errors
and
Increase
Income
A
simple
example
of
why
outsourcing
ICD-‐9
coding
to
a
certified
home
health
consultant
may
be
the
right
answer
for
your
agency:
If
a
home
health
agency
assesses
20
new
referrals
a
week,
or
80
cases
a
month,
it
can
mean
a
potential
gain
of
up
to
an
additional
$96,000
per
month
from
accurate
review
and
coding.
The
cost
of
outsourcing
the
ICD-‐9
coding
and
OASIS
review
for
that
number
of
cases
is
approximately
only
$3,600.
That’s
a
pretty
simple
equation.
Plus,
agencies
don’t
have
to
waste
internal
resources
on
coding
activities,
freeing
them
up
to
focus
on
other
areas
of
the
business.
3. With
ICD-‐10
on
the
horizon,
there’s
simply
no
margin
for
error.
You
need
to
make
sure
your
agency’s
billing
is
accurate
and
compliant,
not
to
mention
ready
to
make
the
transition.
Kenyon
HomeCare
Consulting
is
experienced
with
OASIS
and
ICD-‐9
best
practices,
along
with
the
new
ICD-‐10
rules.
Our
home
health
consultants
can
evaluate
your
current
billing
practices
and
find
more
efficient
ways
to
ensure
you
don’t
lose
revenue
due
to
simple,
but
critical,
ICD-‐
9
coding
errors.
Schedule
an
appointment
at
www.KenyonHCC.com
today
to
learn
more
about
the
benefits
of
outsourcing
your
home
health
agency’s
ICD-‐9/10
coding.