Experts Answer Questions on Properly Documenting the Physician Certification of Terminal Illness in New TrainingCMS has requested that CGS issue the following revision of their Q&A from their Terminal Illness webinar last month. Questions and Answers We recently received information from the Centers for Medicare & Medicaid Services that telehealth face-to-face visits are acceptable until 12/31/24 and are being evaluated for future use as well. Can you please confirm?
If the CTI is not completed by the hospice physician team on the third day after the start of the episode, does the agency perform an administrative discharge and readmit the patient or bill with condition/occurrence code 77 for non-billable days?
There is no diagnosis code to document when you are using non-disease-specific guidelines, correct? If a provider says the patient is eligible under the non-disease-specific guidelines, finding an ICD-10 to use as primary can be a struggle.
Is continuous home care [r20.rs6.net] available for use if a caregiver is not available to provide care (e.g., the caregiver has surgery)?
When using the LCD non-disease-specific guidelines, do you always pick the primary diagnosis as the most likely, even if the patient doesn't exactly meet the disease-specific guidelines for that diagnosis? We see this a lot when patients have a multi-diagnoses reason for qualifying.
When a patient elects a primary care provider who is an NP, is the hospice-employed medical director CTI enough or does the NP's overseeing physician need to sign CTI?
Are co-morbidities required on the CTI?
Is a physician's order required to do a start of care (SOC) assessment by the registered nurse?
Is a new CTI required if a patient transfers to our hospice in the middle of a benefit period, or is the one from the previous hospice sufficient?
Can an NP remain as the attending for the patient when they are put on hospice?
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