New Referral Requirements
Please call our Intake Department at (585) 787-8338 with any questions.
Shorter Timetables for Physician Orders and Signature
- Under Medicare, agencies must have all orders, including the Plan of Care, back in the office with your signature, date and time before any billing can be completed
- Complete and sign orders in 5 business days necessary because claims are submitted every 30 days over the course of a 60-day plan of care
More Specific Primary Diagnoses
The following are key examples of primary diagnoses.
Rejected Referral: M25.561 - Pain in right knee
- Accepted: Tight knee pain due to baker’s (Popliteal) cyst, patellar tendinitis OR
- Accepted: Right knee derangement due to old meniscus tear
Rejected Referral: M62.81 - Muscle weakness (generalized)
- Accepted: Sarcopenia OR
- Accepted: Rhabdomyolysis OR
- Accepted: Amyotrophic lateral sclerosis
Rejected Referral: Muscle wasting and atrophy (Need site and laterality)
Rejected Referral: R78.81 - Bacteremia
- Accepted: Source infection that the bacteria is originating from has to be known. Example sources of infection:
- Urinary tract infection
- Infection originating from a cutaneous wound such as an ulcer, traumatic wound, abscess
- Osteomyelitis (Please specify site and chronicity)
Co-morbidities Drive the Level of Service Reimbursement
Co-morbidities will drive the level of service that Home Care is reimbursed in this new model. This is driven by the up-to-date problem list.