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Hospice - Verbal and Written Initial certification

  • 1.  Hospice - Verbal and Written Initial certification

    Posted 08-14-2020 13:51
    Looking for expertise in hospice - Does the physician who gives the verbal cert for admission have to be the same physician who writes the certification?  I can not find specific regs that speak to the same physician or not.

  • 2.  RE: Hospice - Verbal and Written Initial certification

    Posted 08-15-2020 06:57
    I use to work in post acute setting.  I would recommend referencing COPs 418.22.  There is a specific subsection for sources if certification. See excerpt below:

    (c) Sources of certification.
    (1) For the initial 90-day period, the hospice must obtain written certification
    statements (and oral certification statements if required under paragraph
    (a)(3) of this section) from--
    (i) The medical director of the hospice or the physician member of the
    hospice interdisciplinary group; and
    (ii) The individual's attending physician if the individual has anattending
    physician. The attending physician must meet the definition of
    physician specified in § 410.20 of this subchapter.
    (2) For subsequent periods, the only requirement is certification by one of the
    physicians listed in paragraph (c)(1)(i) of this section

    Diane Lerch
    Division Director of Coding and CDI
    Tampa General Hospital

  • 3.  RE: Hospice - Verbal and Written Initial certification

    Posted 08-15-2020 09:16
    Thanks Diane

  • 4.  RE: Hospice - Verbal and Written Initial certification

    Posted 08-17-2020 10:27
      |   view attached
    Good morning Barbara! Kelly McLendon let me know you had asked this, so I phoned a friend who works for a Hospice in Florida.

    She indicated her company has in place that physicians often cover for one another so they allow one to give the verbal and another to give the written certifications.

    She did also point me to the CMS Manual, which I've attached the section she suggested.

    I hope this helps!

    Kelly Cooper, RHIA, CCS
    Regional HIM
    Florida - SNF/LTC/LTPAC

  • 5.  RE: Hospice - Verbal and Written Initial certification

    Posted 08-18-2020 14:05
    Thanks Kelly-
    I've read Chapter 9 backwards and forwards - to find the exact wording on this - but what  your friend said is of great value.

    Barbara Naimark
    Compliance Manager

  • 6.  RE: Hospice - Verbal and Written Initial certification

    Posted 11-30-2020 15:29
    I am in hospice/home health as well, but for some reasons I missed your question. You already have your answers, but I just wanted to add that both the medical director and the attending physician have to sign. It is best to not have one of your facility's physicians just give the verbal, another write the certification with the narrative statement in addition to the attending's signature.
    It is doable; however, when it is time to fulfill ADR, it can be troublesome. I have been through that! Medicare contractors may want you to provide the written certification of the physician (medical director) who gave the verbal order at your facility level. That is why in our organization we have implemented that the verbal order must come from the physician who writes the statement.
    In regards to external attending physicians, different physicians can do that. One can give the verbal and one signs as the attending.

    Louise Boucicaut MS, RHIA
    Corporate Medical Records Manager
    Community Hospice and Palliative Care