As finalized in Medicare Program FY 2019 Hospice Wage Index and Payment rate Update and Hospice Quality Reporting Requirements rule in the Federal Register and Medicare Change Request 10573, Hospice agencies will no longer be required to submit details of Hospice medication refills. A summary line item for specific revenue codes is still required. Although, Agencies may still choose to submit detailed medication refills on claims without fear of claim denial.
Injectable medication refill reporting with revenue code 0636 in detail or summary on claims IS NO LONGER REQUIRED.
Non-injectable medication refill reporting for revenue code 0250 is required as a summary line item on claims with the total for the invoicing period. HCPCS or NDC codes will not longer be required. Agencies may continue to import non-injectable medication through the Hospice medication import for continued detailed claim reporting.
IV Pump and IV Pump Medication refills for revenue codes 0294 and 029x will be required as a summary line item on claims. Detailed reporting o f IV pump and IV Pump medication refills on a hospice claim will not be cause for denial.
Agencies are recommended to work with their administration and the agency Hospice Pharmacy related to determining a practice continuing detailed medication refill reporting or a change to summary line items on claims.
Agencies who have determined to report summary line items for non-injectable medication refills, IV Pump and IV pump medication refills will continue to add a Billing Sheet (Hospice Drugs) in the patients activity screen to record a line item entry summarizing the totals for each of the three revenue codes as applicable for each invoice period.

Available with Main Office software version 6247 and Clinical Point of Care software version 2643 dated 12-12-17, a new field has been added to the Medication Grid.
Agencies may now indicate who is the responsible party for medication administration for each prescribed medication entered into a patient’s medication grid.
The entered Administration Responsibility will be included in the medication snap shot for the Plan of Care and on the Medication Profile and medication treatment sheets.
Hospice agencies will now also see the entered payer responsibility for each prescribed medication in the medication snapshot for the Hospice Plan of Care and the Medication profile.

Agencies utilizing server based Clinical Point of Care software with the Pepid Drug Interaction interface will need to have all Clinical Software users update the software to Version 2305 or higher dated 4/7/15 or later.  Once the clinical software has been updated, clinical software users will need to perform the “Download latest data from the server and update this computer” task in the Data Transfer and Update Utility screen.  The required files and data will then be available for the clinician to perform the Pepid drug interaction check.

To perform a Pepid drug-drug Interaction check, all medications must be entered into the Patient Medication grid as a Pepid database medication.  Pepid medications must be selected from the Base medication Look up box and will have Pepid notated in parentheses.  Medications not designated or associated with the Pepid medication database will not be included in the drug-drug interaction check.

Server based Clinical Software users must have an internet connection to perform a Pepid drug-drug interaction check.

The patient medication grid will now display a new button, ‘Check Pepid Interactions.  Once selected the software will provide a notification the interaction check is processing.  Once completed the software will provide a view screen displaying any drug-drug interactions with a severity rating.  The Clinician has the opportunity to create a communication note labeld as Medication Interaction Check that will be saved as a historical record in the patient activity screen and printed for submission to the physician.

Additionally, Clinicians may create a Med Sheet activity.  Selection is available from the Add an Activity screen when the green plus button is selected from the patient activity screen.  Medications already entered in the patient Medication grid may be imported into the Med Sheet by selecting the “Load Patient meds” button.  The Check Pepid Interaction button can be found at the bottom right corner to perform the drug-drug interaction check.  The med Sheet will save as a historical document to the patient’s activity screen.

Buttons are also available to View prior results of an interaction check.

Beginning with software version updates available after 10/23/14, Allegheny Software Publishers, Inc. has enlarged the data entry screens found within the Patient Database to accommodate many of the new upgrades to the software.

Available with software version 5424 is a Hospice Medications Import Screen in the Utilities Module of the Main Office Software.  Hospice Medication refills in  CSV or XLS (Microsoft Excel) format can now be imported to create a Billing Sheet for each Hospice Patient with Medication refills.  Agencies will still need to set up appropriate service codes for refill type as this is a required column mapping item.  Each Patients Billing Sheet will be included in invoicing to meet the new Hospice Billing Requirements.

We have added a new activity type under patients called a “Billing Sheet.”  This new billing sheet will give you the ability to include the Hospice medication changes in the ANSI 5010 billing that will become a requirement as of April 1, 2014.  Only certain revenue codes will appear in the drop downs boxes when a user is in the billing sheet.  There is a new check box in services labeled “Allow to show on Billing Sheets” which if checked, will allow the revenue code to be available in the billing sheets.  There is also a new check box in services labeled “Do not post to Accounts Receivable” to give users the ability to make sure charges for medication changes included in billing do not post to to accounts receivable.

Available on version 4564 is an additional ‘Signature indicates’ option has been added to the Patient Medication Profile sheet printout.

We previously had a statement that stated ‘Signature indicates review of medications (dose, effect, adverse effect, duplicate treatment, drug interactions, need for patient education, new/changed medications.’

At a customer request, we have added a second option, specifically for Hospice purposes that has ‘associated laboratory monitoring’ in it – so that statement reads: ‘Signature indicates review of medications (dose, effect, adverse effect, duplicate treatment, drug interactions, associated laboratory monitoring, need for patient education, new/changed medications.’

The Patient Duplicate Drug Classifications report was not working due to changes in how medications were assigned drug classifications back in 2008.  Prior to 2008 drug classifications were assigned by selecting drug classification check boxes under Medications under a drug classifications tab that no longer exists .  Drug classifications are now assigned from two drop down boxes on the main Medications maintenance screen.  The report now reflects the new method of assigning drug classifications.

In order for the report to work properly two things must be in place.  First, drug classifications have to be assigned to your medications.  Second, when entering in medications on a patient, you must use the medication look-up field just in front of where you enter the medication name.  If you skip this field and key directly into the medication name field then there is no tie-in to the medication table needed to look-up the classification.

Available on version 4507 is a change to the Patient Meds Sheet.  In the past if you printed the Meds Sheet and put a checkmark in ‘New Medications Only‘ or ‘Changed Medications Only‘ and then didn’t have any new or changed medications it would give an error ‘List Index Out of Bounds‘ – on version 4507 we remove the error and if you put a checkmark in ‘New Medications Only‘ or ‘Changed Medications Only‘ we print the sheet with the words ‘No New Medications‘ or ‘No Changed Medications‘.

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