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Hospice Clinical Documentation Hospice Clinical Documentation Hospice Clinical Documentation (PDFDrive)
Hospice Clinical Documentation Hospice Clinical Documentation Hospice Clinical Documentation (PDFDrive)
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HOSPICE COVERAGE
Hospice Coverage
• Technical requirements for hospice coverage:
– Notice of Election (NOE)
• Prior to Hospice admission:
– Certification of Terminal Illness (CTI)
• Required for each benefit period:
– Face-to-Face Encounter documentation
• Required for each third and later benefit period.
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Hospice Coverage
• Clinical documentation requirement for
hospice coverage:
– Patient record must support documentation in
technical elements.
• Terminal prognosis of 6 months or less
• LCD criteria
– Days in any billing period without corresponding
documentation showing eligibility are unpaid.
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• Plan of Care
–All IDG members contribute
Pl a n
• Plan of Care
–Based on assessment assessments
• Initial, comprehensive, and updated
–Individualized
–Specifies care and services needed
• To meet patient and family-specific needs
• Related to the terminal illness and
related conditions.
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• Documentation must
show that hospice care
and services:
–Are directed, coordinated,
and supervised by the IDG;
–Follow the plan of care;
–Are based on patient and
family need assessments;
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– OK as contributing diagnoses.
Lesson 5
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OR
– Guidelines in both
• Baseline non-disease specific guidelines in part 2
+
• The applicable, disease-specific lists in the appendix
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References
• CMS Coverage Manual Chapter 09 Hospice
• MM7337
• State Operations Manual Appendix M -
Hospice Interpretive Guidelines
• Hospice LCD via CGS Medicare
Thank You!
Beth Noyce, RN, BSJMC, HCS-C, COS-C
bethnoyce@gmail.com
Copyright 2014
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