Palmetto releases RCD checklists


A “cheat sheet” for the Review Choice demonstration is available again

If you felt a little like the victim of a game of “now you see it, now you don’t” when Medicare administrative contractor Palmetto GBO released – and then pulled – a checklist of necessary documentation needed for pre-claim reviews, there’s good news.

The checklist is back, just in time for the June 1 launch of the Review Choice demonstration in Illinois – and there’s a bonus: a Pre-Claim Review Subsequent Episode Checklist has been made available, too.

Palmetto shared the revised version of its Pre-Claim Review Initial Checklist with the Subsequent Episode Checklist with home care providers during an educational webinar this morning, and said it will make available copies of the checklists and all slides from the webinar a little later.

Additional topics covered during the webinar include a list of 15 HCPCS codes subject to the pre-claim review demonstration, guidelines for establishing homebound eligibility and the need for skilled services, and multiple lists of supporting documentation needed to support the face-to-face encounter between patient and physician.

“Palmetto reinforced the need for home care providers to provide an actual clinical note for the face-to-face encounter,” said J’non Griffin, owner and president of Home Health Solutions. “An office visit note or documentation from the hospital or post-acute facility will be required.”

Face-to-face encounter forms created by the agency and sent to the physician to complete will not be accepted, she said. (Need help getting the face-to-face encounter documentation right? Check out our $24.99 guide to the 12 most common errors. It's sold in our online store, The Solutions Shop.)

The RCD checklists

Palmetto’s Pre-Claim Initial Review Checklist includes a reminder to agencies that when the face-to-face encounter has been performed by someone other than the certifying physician, a statement of collaboration should be included. It should be signed by the certifying physician.

The checklist also clarifies which items need to be signed by the physician and under what circumstances. The Subsequent Episode Checklist uses the same format as the Initial Checklist but addresses specific items of documentation needed for later episodes. For example, it adds current physical therapy assessment, current occupational therapy and current speech language pathology assessment to the list of documentation required.

Click here to access the Pre-Claim Initial Checklist now.


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