presented by Annette Lee
Financial— Annette Lee is the owner of Provider Insights Inc and receives compensation from MedBridge for the production of this course. There are no other relevant financial relationships. Nonfinancial— No relevant nonfinancial relationship exists.
Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.
Annette Lee, RN, MS, HCS-D, COS-C
Annette Lee, RN, MS, HCS-D, COS-C Annette is a registered nurse who has been practicing since 1990, with the majority of her nursing experience being in public health care. She has a master’s degree in Health Care Administration. In 2000 she joined the home health intermediary Cahaba GBA, where she became an instructor, providing education…Read full bio
1. What Is Observation and Assessment per CMS?
This chapter will provide a clear definition of O&A per CMS. We will discuss the vital difference between “skilled” and “billable/covered,” and where to find these definitions in writing. This understanding is mandatory for home health nurses because it is up to each clinician to determine eligibility, both at the Initial Assessment and ongoing throughout care.
2. Clinical Indications and Exceptions for Assessment
CMS provides a list of circumstances in which they feel assessment would be a covered service. We will discuss these “clinical indications,” along with the counter-balance of the exceptions rules that CMS also provides.
3. Assessment Examples
This chapter uses both “real life” and “Chapter 7” examples of when CMS would pay for assessment, and when there would be risk for denial. These examples include everything from simple wound care to hypotension.
4. Documenting the Skill
Lastly, the documentation must show the level of skill, plus the medical necessity of this service. This chapter will discuss ways to ensure that your payment is protected with proper documentation of this service.