US · guidance
CMS Pub. 100-08, ch. 6, § 6.2.4
Coding
If the patient’s comprehensive assessment or recertification assessment was signed off
and incorporated into the certifying physician’s medical record for the patient (or the
acute/post-acute care facility’s medical record if the patient was directly admitted to
home health), contractors shall use it to determine whether the Home Health Resource
Group (HHRG) codes billed were accurate and appropriate. In addition, if the
comprehensive assessment is incorporated into the certifying physician’s record for the
patient and is used to support that the patient meets the home health eligibility criteria,
then the diagnoses and conditions listed on the start of care assessment must be
corroborated by information in the certifying physician’s and/or the acute/post-acute care
facility’s own medical record documentation.
The contractor shall use the web regrouping program provided by CMS to recode claims
as appropriate.
History
(Rev. 603, Issued: 07-21-15, Effective: 08-11-15, Implementation: 08-11-15)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
a519f966ff89e9ebe3c8edc20ce288321530bb28c6bc26d41662e2ace47e3592
The link goes to the issuing authority’s own document — the one we read to produce this record. Where a source publishes whole titles rather than sections, your browser may need a moment to jump to the provision.
Unofficial copy of government-published law, reproduced from official sources with full provenance. Not an official publication; verify against official sources before relying on it in a filing. Records in the 'guidance' corpus, and only that corpus, are sub-regulatory (interpretive guidelines, survey procedures) and are not binding law. Validity bounds follow each jurisdiction's declared temporalBasis.