The purpose of this information letter (IL) is to provide information and guidance on the use of Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), when submitting the International Classification of Diseases, Version 10 (ICD-10) diagnosis codes in Field 27 of the Intellectual Disability/Related Condition (ID/RC) Assessment (Form 8578).Effective October 1, 2015, the Centers for Medicare and Medicaid Services (CMS) will require healthcare providers and governmental … [Read more...] about Use of Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Field 27 of the Intellectual Disability/Related Condition Assessment
Discontinuation of the Intellectual Disability/Related Condition Purpose Code E
The purpose of this information letter (IL) is to inform Home and Community-based Services (HCS) providers, Texas Home Living (TxHmL) providers and Local Intellectual and Developmental Disability Authorities (LIDDAs), effective November 1, 2015, the Department of Aging and Disability Services (DADS) is discontinuing submission of Purpose Code E (PC E) Intellectual Disability/Related Condition (ID/RC) forms to cover a gap in ID/RC authorization time periods. No other ID/RC purpose code … [Read more...] about Discontinuation of the Intellectual Disability/Related Condition Purpose Code E
New Billing Codes and Payment Rates for Hospice Physician Directed Care Claims
Effective October 1, 2015, the Texas Department of Aging and Disability Services (DADS) implemented new billing codes and payment rates for Medicaid Hospice (Service Group 8) / Physician Direct Care services (Service Code 30). Each procedure code for physician directed care services has two new billing codes and payment rates. The new billing codes and payment rates are age-specific, one set of billing codes for services to individuals less than 21 years old and another for individuals 21 … [Read more...] about New Billing Codes and Payment Rates for Hospice Physician Directed Care Claims
CALIFORNIA’S NEW PAS LAW EVOKES WIDESPREAD RESPONSE
California joined four other states that allow physician-assisted suicide after Governor Jerry Brown, D-CA, signed the End of Life Option Act into law. The measure allows physicians to prescribe lethal doses of drugs to terminally ill patients diagnosed with fewer than six months to live. Limitations apply, as described below. The bill will take effect 90 days after the California legislature ends it session on healthcare. Predictions are that this will happen between January and November 2016. … [Read more...] about CALIFORNIA’S NEW PAS LAW EVOKES WIDESPREAD RESPONSE
Hospice – Advance Directives
Advance DirectivesThe 84th Legislative Session passed HB 3074, relating to the provision of artificially administered nutrition and hydration and life-sustaining treatment. Chapter 97 Home and Community Support Services Agencies Licensure rules require hospice agencies have policies in compliance with the Texas Health and Safety Code Chapter §166 Advance Directives. DADS staff are working on updating the advance directive forms. DADS Regulatory will be notifying providers of the … [Read more...] about Hospice – Advance Directives
CMS Published New ICD-10 Blog
ICD-10 Ombudsman and ICD-10 Coordination Center Here to Support Your Transition NeedsIt’s important that you know help’s available if you have problems with ICD-10:The ICD-10 Ombudsman, Dr. Bill Rogers, can be your impartial advocate. Dr. Rogers, a practicing emergency room physician, is known to many of you already. Since 2002, he has been the Director of the Agency’s Physicians Regulatory Issues Team, assisting physicians, other practitioners, and medical societies in identifying and … [Read more...] about CMS Published New ICD-10 Blog
Day Activity and Health Services Eligibility Criteria and Eligibility Assessment Procedures
DAHS providers that have a DAHS contract with the Texas Department of Aging and Disability Services (DADS) are advised of revised eligibility criteria and assessment procedures.Pending completion of proposed rule amendments to Texas Administrative Code (TAC), Title 40 Part 1, Chapter 48, §48.2915, providers of DADS DAHS are notified effective October 15, 2015, the following eligibility criteria will apply:? DAHS services must be prescribed by a physician who has certified that the individual … [Read more...] about Day Activity and Health Services Eligibility Criteria and Eligibility Assessment Procedures
ICD 10; what to do with difficult submissions
As you know, ICD 10 begins October 1, 2015. CMS MLN released information to providers on claimsubmission alternatives when you have difficulties submitting ICD-10 claims due to being unable tocomplete necessary systems changes or having issues with billing software, vendor(s), orclearinghouse(s). The article states that the following claims submission alternatives are available: Freebilling software, provider internet portals, direct data entry (DDE), and paper claims. Each … [Read more...] about ICD 10; what to do with difficult submissions
HCS Dental Limit Increased to $2000/year 9/1 Documents You Need to Proceed
Information Letter No. 2015-51 - Service Limit Increase for Dental Treatment in the Home and Community-based Services ProgramAddressed to:Home and Community-Based Services (HCS) ProvidersLocal Intellectual and Developmental Disability AuthoritiesHome and Community-based Services (HCS) Program Billing Guidelines09/01/2015 05:30 AM CDT Dental Limit Increase Questions about Dental Requisition Fees?Check page 2 of "HCS Rates Effective September 1, 2015."Visit us at Garlo Ward, PC … [Read more...] about HCS Dental Limit Increased to $2000/year 9/1 Documents You Need to Proceed
Revised HCS, CLASS, DBMD, TxHmL Forms – Includes HCS Transportation, TAS, and Pre-Enrollment Minor Home Modifications
DADS has published the following revised forms related to transportation, transition assistance services (HCS only), and pre-enrollment minor home modifications (HCS only). Please begin using the current versions of these forms during the service planning process. As the agency continues to release new or revised forms, providers will be notified.Revised forms:Form 3595 - IPP Service ReviewForm 3598 - Individual Transportation PlanForm 3608 - Individual Plan of Care (IPC) - HCS/CFCForm … [Read more...] about Revised HCS, CLASS, DBMD, TxHmL Forms – Includes HCS Transportation, TAS, and Pre-Enrollment Minor Home Modifications
