Medical Necessity at Recertification | Documentation Tips, Common Errors & OASIS Examples

Ensuring medical necessity at recertification is one of the most critical — and frequently cited — compliance challenges in home health. In this AHCC Talk episode, host Jan Milliman, HCS-D and Lisa McClammy, BSN, RN, COS-C, HCS-D, HCS-O walk through: ✔️ What Medicare reviewers look for when evaluating recertification ✔️ Documentation elements that support continued skilled services ✔️ Common documentation gaps that lead to denials ✔️ How functional status, progress to goals, and risk factors support coverage ✔️ Real-world examples of skilled nursing, observation, and teaching services The episode concludes with a Scenario Spotlight covering OASIS M1033.1 – History of Falls, helping viewers test their OASIS knowledge. 🔔 Ideal for home health clinicians, coders, QA staff, and compliance leaders looking to improve documentation accuracy and reduce audit risk. Links Mentioned in the Episode 🔗 AHCC certification study guides: decisionhealth.com/studyguides 🔗 If you're an AHCC member, register for the AHCC Member's Call on January 28 at 1pm EST: https://register.gotowebinar.com/register/8915984221266150240 🔗 Learn more about AHCC and how to become a member: store.decisionhealth.com/join-ahcc 🔗 Join us for the next live airing of AHCC Talk: https://attendee.gotowebinar.com/register/2224811617290518541?source=yt ⬇️ Downloadable slides from this discussion: https://ahcc.decisionhealth.com/ahcc-talk-episode-86-medical-necessity-at-recert/ 📧Have a question, episode request, or suggestions for a future panel guest? Email Jan at [email protected]