North Carolina

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CareBridge EVV Integration Guide and Technical Specifications


INTRODUCTION TO CAREBRIDGE INTEGRATION


OVERVIEW

Welcome! This Integration Guide is intended to help providers and EVV Vendors throughout the process of integrating with CareBridge to provide EVV data for the purposes of data aggregation. If at any point you have questions, our team here is here to help: evvintegration@carebridgehealth.com. A PDF of this guide is available here


WHAT IS CAREBRIDGE?

CareBridge is a company formed to support care for people who receive Long-Term Services and Supports (LTSS). We offer LTSS solutions including an Electronic Visit Verification Platform that can be utilized via a mobile phone, GPS-enabled tablet, landline and web-based portal to record service delivery and facilitate day-to-day management of members’ appointments. CareBridge also supports a wide array of EVV data aggregation solutions in which CareBridge builds an integration with a provider’s EVV system, allowing provider agencies to keep their current EVV solution while still providing required data back to the health plan or state.


INTEGRATION OVERVIEW

CareBridge will engage providers that choose to integrate CareBridge's Platform with a 21st Century Cures Act compliant EVV solution. CareBridge's Platform supports data aggregation by way of accepting EVV Visit Data from Third-party vendors and subsequently generating claims to be submitted to the clearinghouse and PHPs.

All EVV Visit and Claims data must ultimately be reflected in the CareBridge Platform for PHP receipt, payment, and monitoring.

The following is a description of the steps in the data aggregation process:

  1. Appointments / Visits data file is placed in SFTP folder by provider and/or Third-party vendor.
  2. CareBridge imports and processes Appointments / Visits file.
  3. CareBridge places response file in SFTP for review by provider and/or Third-party vendor.
    • Provider takes action on response errors and resubmits visits.
      • It is the responsibility of the Third-Party EVV Vendor to ensure providers can correct errors within their EVV system and are able to resubmit the corrected visits to CareBridge.
      • CareBridge provides daily reports on outstanding pre-billing errors via the supplemental
        Pre-Billing Validation Report
        .
  4. CareBridge utilizes visits data to generate claims and submits to clearinghouse / PHPs.
  5. CareBridge provides daily updates on visit status via the supplemental Appointment Status Report.
  6. Providers can continue to receive claim remittances through previously established mechanisms (Availity).

The supplemental report specifications can be found on the CareBridge EVV Data Integration web page: http://evvintegration.carebridgehealth.com, under Additional Documents for Third-Party Vendors.

Appointments / visits data should be submitted to CareBridge at least once daily for all appointments / visits that have had incremental changes since last submission.

Do not continue to re-send appointments / visits that have not changed unless instructed by CareBridge. If a visit has been sent with ClaimAction 'N', do not re-submit until it reaches a terminal status (Rejected, Paid, Denied), or an error was included for that visit in the CareBridge Response File.

SFTP CONFIGURATION REQUIREMENTS

  • CareBridge test environment: sftp.dev.carebridgehealth.com
  • CareBridge production environment: sftp.prd.carebridgehealth.com
  • Port: 22
  • Login Credentials: Vendor's public SSH key
  • When transferring files via SFTP, select BINARY mode


SFTP FOLDER STRUCTURE

/input – Used to send files to CareBridge for import into the CareBridge system
/output – Used to retrieve Response Files from CareBridge


SFTP RETENTION POLICY

  • Once files have been downloaded from /output, they should be deleted. If they are not deleted, they will be retained for 30 days.
  • Files will be deleted from /input upon load and processing by CareBridge.


FILE FORMAT SPECIFICATIONS

  • File type: CSV (pipe-delimited).
  • Values can be enclosed with double quotes (and should be when a pipe could exist in the data).
  • Headers should be included.
  • One row per appointment / visit.
  • All DateTime fields should be UTC.
  • Visit data will be rejected if there is already an existing ApptID that has been claimed but has not yet reached a terminal status (Rejected, Paid, Denied).


NAMING CONVENTION

Visit Files from Third Party EVV Vendors

The general naming convention is as follows:
VISITS_NC_ProviderTaxID_YYYYMMDDHHMMSS.CSV


For Test Files, “TEST” will prepend the file name as follows:
TEST_VISITS_NC_ProviderTaxID_YYYYMMDDHHMMSS.CSV

Note: The state initials are required for files to be processed.

CareBridge Response File

VISITS_NC_ProviderTaxID_ERROR_YYYYMMDDHHMMSS.txt

 

For Test Files, “TEST” will prepend the file name as follows:

TEST_VISITS_NC_ProviderTaxID_ERROR_YYYYMMDDHHMMSS.txt

 

TESTING INSTRUCTIONS

Testing Overview 

Vendors are required to complete testing scenarios in order to begin sending production data to CareBridge.

The goal of the testing process is to ensure that data is able to be successfully transmitted from Third-party vendors to CareBridge. CareBridge has created several test cases designed to ensure specific scenarios are understood and passed by vendors prior to production go-live.

The test cases are outlined in a separate document: North Carolina - Third-Party EVV Vendor Integration Testing Process Guide, available on the CareBridge EVV Data Integration web page: http://evvintegration.carebridgehealth.com, under Additional Documents for Third-Party Vendors > North Carolina - Third-Party EVV Vendor Integration Testing Process Guide.

Additionally, there are 3 different testing milestones summarized below:

  • Connection Testing – Vendors credentials are working properly and they are able to successful connect to the SFTP site.
  • File Validation Testing – Vendors are able to successfully send files in accordance with file specifications.
  • Data Validation Testing– Vendors are able to send records in accordance with data specifications.


Initial Production Data Go-Live

Once a vendor has successfully completed the required test cases and is approved to send data to production, they can begin sending production appointment/visit data to the production environment.

CareBridge highly recommends that EVV Vendors follow the process outlined below:

  1. Send a file in the production environment with actual visit/appointment data.

    a. Only sending 1-5 rows of data initially.
    b. Sending visit data with the ClaimAction field as null.
    c. At least one row of data be visit data rather than appointment data.

  2. Download the response file in the /output folder and review the pre-billing errors.
  3. Update data to remedy those errors; email evvintegration@carebridgehealth.com with questions about specific errors.
  4. Repeat steps 1-3 until you receive a response file with headers only. This means that there were no row level errors and the data was processed successfully.
  5. Repeat steps 1-4 for each unique provider agency TIN for whom you provide EVV services.

Claim Submitted via CareBridge

Once a vendor is able to successfully send a file of appointment/visit data without errors on behalf of a provider, they can coordinate with the provider to submit their first claim.

  • Re-send the visit data previously sent in Initial Production Data Go-Live with the ClaimAction field as 'N'. This will generate a claim for those visits.

Note: If visits sent in Data Validation Testing – Production included the ClaimAction field as 'N' rather than null, both Data Validation in Production and Claim Submitted via CareBridge would be completed simultaneously.


Integration "Go-Live" 

Once a vendor is able to successfully submit a claim via CareBridge, they can begin implementation of Integration Go-Live – submitting all claims via CareBridge.

This will require coordination between the vendor, the agency(ies) they support and CareBridge.

The process is as follows:

  1. Direct providers using your system to the CareBridge Integration Document for Providers site. It contains instructions for their expectations and next steps.
  2. Identify a go-live date with each agency to begin sending all data and communicate that date to CareBridge.
  3. Develop a process with your agency for resolving response file errors on an ongoing basis.
    • It is up to vendors and their agencies whether response files will be passed to their agencies directly or incorporated into the Third-party EVV system’s UI.
    • It is required that vendors leverage both the:
          1. The Pre-Billing Validation Report in addition to response files to ensure providers have the most up-to-date information regarding outstanding visit errors.
          2. The Appointment Status Report to ensure providers have accurate information regarding visit or claim status over time.
    • Integrating agencies will not be able to make updates to their data in the CareBridge EVV portal. Updated data should be sent via integration process.

DATA FIELD SPECIFICATIONS

CareBridge Response File Format

Field Value Description
ERROR_CODE See sections below The error code indicating the type of issue
ERROR_DESCRIPTION See sections below The description of the error code, this is dynamic based on the error
IS_FILE_ERROR True or False Indicates if the error is a file level error or row / field level error
ERROR_SEVERITY ERROR or WARNING Indicates the severity of the error
FILE_NAME Name of the inbound file Name of the file that was received by CareBridge

In addition to these 5 fields, the CareBridge response file will also contain each field included in the inbound data file for Third-Party EVV Vendor reference.


File Level Validation

Error Number Description
F1001 Unknown file
F1002 Incorrect delimiter
F1003 Data cannot be parsed, it may be incomplete or invalid
F1004 File is a duplicate
F1005 File exceeds max allowed file size. (5 GB)

 
Appointments / Visits Data File Format

Field No  Field Name Description  Data Type Required for Scheduled Appointment Required for Completed Visit Example Max Length

1

VendorName 

Name of EVV vendor sending data

Alphanumeric

Y

Y

EVV Vendor

 

2

TransactionID 

Unique identifier for the transaction and should be unique in every file. It is only used for tracking and troubleshooting purposes

Alphanumeric

Y

Y

71256731

 

3

TransactionDateTime 

Time stamp associated with the visit data being sent to CareBridge
in UTC

Datetime

Y

Y

YYYY-MM-DDTHH:MM:SSZ

“2020-01-01T14:00:00Z”

 

4

ProviderID 

Unique identifier for the provider
(in third party EVV system)

Alphanumeric

Y

Y

43134

35

5

ProviderName 

Name of provider 

Alphanumeric

Y

Y

Home Health, LLC

255

6

ProviderEIN 

Tax ID or EIN of provider 

Alphanumeric

Y

Y

208076837

9

7

ProviderNPI 

NPI of provider 

Numeric

Y
(required unless the provider is atypical)

Y
(required unless the
provider is atypical)

1609927680

10

8

ProviderAtypicalID

Atypical ID if provider does not have NPI

Alphanumeric
(required format
8 digits)

Y
(required if the
provider is atypical)

Y
(required if the
provider is atypical)

98212356

8

9

ProviderMedicaidID

MedicaidID number for Provider

Alphanumeric

N

N

2548369715

10

10

ApptID 

Unique identifier for the visit, used to identify an appointment and should be consistent for every appointment update

Alphanumeric

Y

Y

1231248391

100

11

CaregiverFName 

First name of caregiver who completed the visit  

Alphanumeric

Y

Y

John

 

12

CaregiverLName 

Last name of caregiver who completed the visit  

Alphanumeric

Y

Y

Smith

 

13

CaregiverID 

Unique ID Assigned to caregiver (Employee ID) 

Alphanumeric

Y

Y

982123

 

14

CaregiverAtypicalID

Caregiver ID assigned by state

Alphanumeric

N

N

54862978

8

15

CaregiverSSN

Employee Social Security Number
(Four zeros + Last 5 digits of SSN)

Alphanumeric

Y

Y

0000#####

9

16

MemberFName 

First name of member

Alphanumeric

Y

Y

Jane

 

17

MemberLName 

Last name of member

Alphanumeric

Y

Y

Johnson

 

18

MemberDateOfBirth

Date of birth of member

Alphanumeric

Y

Y

YYYY-MM-DD

 

19

MemberMedicaidID 

Medicaid ID for member 

Alphanumeric

Y

Y

128459972B

10

20

MemberID 

Member ID in Vendor System

Alphanumeric

N

N

47138493

 

21

ApptStartDateTime

Date / Time that the appointment was scheduled to begin in UTC

DateTime

Y

Y

YYYY-MM-DDTHH:MM:SSZ

“2020-01-01T14:00:00Z”

 

22

ApptEndDateTime

Date / Time that the appointment was scheduled to end in UTC

DateTime

Y

Y

YYYY-MM-DDTHH:MM:SSZ

“2020-01-01T14:00:00Z”

 

23

ApptCancelled

(C) if appointment was cancelled

Alphanumeric

N

N

C

 

24

CheckInDateTime 

Date / Time that the visit was checked into in UTC

Datetime

N

Y

YYYY-MM-DDTHH:MM:SSZ

“2020-01-01T14:00:00Z”

 

25

CheckInMethod

EVV (E), FOB (F), IVR (I), Manual (M)

Alphanumeric

N

Y
(if ‘M’ CheckOutMethod
must be ‘M’)

E

 

26

CheckInStreetAddress 

Street address where check
in occurred

Alphanumeric

N

Y

926 Main St

 

27

CheckInStreetAddress2 

Additional street address info where check in occurred

Alphanumeric

N

N

Suite B

 

28

CheckInCity 

City where check in occurred 

Alphanumeric

N

Y

Nashville

 

29

CheckInState 

State where check in occurred  

Alphanumeric

N

Y

TN

 

30

CheckInZip 

Zip code where check in occurred

Alphanumeric

N

Y

37206

5

31

CheckInLat

Latitude of coordinates where check in occurred

Alphanumeric

N

Y, if
CheckInMethod=E

##.######

 

32

CheckInLong 

Longitude of coordinates where check in occurred 

Alphanumeric

N

Y, if
CheckInMethod=E

###.######

 

33

CheckOutDateTime 

Date / Time that the visit was checked out of in UTC

Datetime

N

Y

YYYY-MM-DDTHH:MM:SSZ

“2020-01-01T14:00:00Z”

 

34

CheckOutMethod

EVV (E),
FOB (F),
IVR (I),
Manual (M)

Alphanumeric

N

Y
(if ‘M’ CheckInMethod
must be ‘M’)

E

 

35

CheckOutStreetAddress 

Address where check out occurred

Alphanumeric

N

Y

926 Main St

 

36

CheckOutStreetAddress2 

Additional address info where check out occurred

Alphanumeric

N

N

Suite B

 

37

CheckOutCity 

City where check out occurred

Alphanumeric

N

Y

Nashville

 

38

CheckOutState 

State where check out occurred

Alphanumeric

N

Y

TN

 

39

CheckOutZip 

Zip code where check out occurred 

Alphanumeric

N

Y

37206

5

40

CheckOutLat 

Latitude of coordinates where check out occurred

Alphanumeric

N

Y, if CheckOutMethod=E

##.######

 

41

CheckOutLong 

Longitude of coordinates where check out occurred 

Alphanumeric

N

Y, if CheckOutMethod=E

###.######

 

42

VisitLocationType

Self-reported visit location

Alphanumeric 

N

Y

(see Location Type Codes Table below)

 

43

AuthRefNumber 

Authorization Number as indicated by health plan

Alphanumeric

Y

Y

unless not required for Service Code (see Home Health Service Codes section below)

1080421390

 

44

ServiceCode 

Service code for services
rendered during visit 
(HCPCS Procedure Code)

Alphanumeric

Y

Y

99509

 

45

Modifier 1 

Modifier code for services rendered during visit

Alphanumeric

N

N

HA

 

46

Modifier 2 

Second modifier code for services rendered during visit  

Alphanumeric

N

N

UA

 

47

RevenueCode

Revenue Code that should be used for billing.  (See table below for additional details)

Alphanumeric

N

Y If Home Health Service Code

See Home Health Service and Revenue Code Definitions below

 

48

TimeZone 

Time zone that the visit
took place in  

Alphanumeric

Y

Y

US/Eastern

 

49

CheckInIVRPhoneNumber 

Phone Number used to 
check in 

Alphanumeric

N

Y, if
CheckInMethod=I

+14156665555

 

50

CheckOutIVRPhoneNumber 

Phone Number used to 
check out 

Alphanumeric

N

Y, if CheckOutMethod=I

+14156665555

 

51

ApptNote 

Free text note related to
the visit

Alphanumeric

N

N

Scheduling related note

 

52

DiagnosisCode 

ICD-10 Diagnosis code attributed to the visit. Must be a valid ICD-10 code if included

Alphanumeric

N

N

I50.9

 

53

ApptAttestation 

Member attestation associated with the visit

Alphanumeric

N

N

See Member Attestation Codes table below

 

56

Rate 

Billed unit rate associated with the visit (see Unit Definitions
Table below)

Decimal

N

Y, if
ClaimAction=N

3.85

 

57

ManualReason 

Reason for manual entry associated with the visit

Alphanumeric

N

Y, if
CheckInMethod or CheckOutMethod=M

See Manual Reasons Codes table below

 

58

LateReason 

Reason the visit was late

Alphanumeric

N

Y
if check in occurred between one and three hours after the scheduled start time

See Late Reasons Codes table below

 

59

LateAction 

Action taken due to visit being late

Alphanumeric

N

Y
if check in occurred between one and three hours after the scheduled start time

See Late Actions Codes table below

 

60

MissedReason 

Reason the visit was missed

Alphanumeric

N

Y
if check in occurred greater than three hours after the scheduled start time

See Missed Reasons Codes table below

 

61

MissedAction 

Action taken due to the visit being missed

Alphanumeric

N

Y
if check in occurred greater than three hours after the scheduled start time

See Missed Actions Codes table below

 

62

CarePlanTasksCompleted

Tilda delimited list of tasks codes completed during the visit

Alphanumeric

N

N

200~270
See Care Plan Tasks Codes table below

 

63

CarePlanTasksNotCompleted

Tilda delimited list of task codes not completed during the visit

Alphanumeric

N

N

280~290
See Care Plan Tasks Codes table below

 

64

CaregiverSurveyQuestions

Tilda delimited list of survey question codes presented to
the caregiver

Alphanumeric

N

N

SQ1000~SQ1005
See Survey Questions Codes table below

 

65

CaregiverSurveyResponses

Tilda delimited list of survey response codes to questions presented to the caregiver in the same order as the questions listed in field

Alphanumeric

N

N

Yes~No

 

66

ClaimAction 

New Claim (N), Void (V), Claims Billed Externally-Not Via CareBridge (E) 

Alphanumeric

N

Y

N

 

67

MCOID 

Identifies health plan the member is associated with

Alphanumeric

Y

Y

See MCOID table below

 

101

Claim Invoice Number 1

Claim level invoice number in third-party system

These fields can be used for reconciliation of the data sent to CareBridge. 

If you would like to use these fields, please contact the CareBridge Integration team at evvintegration@carebridgehealth.com

To enable these fields, additional testing is required.

102

Claim Invoice Number 2

Claim level invoice number in third-party system

103

Line Item Invoice Number 1

Unique identifier of the invoice line item in the third-party

104

Line Item Invoice Number 2

Unique identifier of the invoice line item in the third-party


PCS Service Codes and Unit Definitions

ServiceCode Modifier1 Unit Quantity Unit Type
99509 HA 15 minutes
99509 HB 15 minutes

 

Home Health Service Codes and Unit Definitions

Service Code

Revenue Code

Revenue Code Description

Auth Required

 Unit Type

Unit Quantity

92521

444

Speech Therapy - Evaluation

No

Visit Per Day*

1

92522

444

Speech Therapy - Evaluation

No

Visit Per Day

1

92523

444

Speech Therapy - Evaluation

No

Visit Per Day

1

97161

424

Physical Therapy - Evaluation

No

Visit Per Day

1

97162

424

Physical Therapy - Evaluation

No

Visit Per Day

1

97163

424

Physical Therapy - Evaluation

No

Visit Per Day

1

97164

424

Physical Therapy - Evaluation

Yes

Visit Per Day

1

97165

434

Occupational Therapy - Evaluation

No

Visit Per Day

1

97166

434

Occupational Therapy - Evaluation

No

Visit Per Day

1

97167

434

Occupational Therapy - Evaluation

No

Visit Per Day

1

97168

434

Occupational Therapy - Evaluation

Yes

Visit Per Day

1

G0151

420

Physical Therapy

Yes

Visit Per Day

1

G0152

430

Occupational Therapy

Yes

Visit Per Day

1

G0153

440

Speech Therapy

Yes

Visit Per Day

1

G0156

570

Home Health Aide Visit

No

Visit Per Day

1

G0157

420

Physical Therapy

Yes

Visit Per Day

1

G0158

434

Occupational Therapy - Evaluation

Yes

Visit Per Day

1

G0159

420

Physical Therapy

Yes

Visit Per Day

1

424

Physical Therapy - Evaluation

Visit Per Day

1

G0160

430

Occupational Therapy

Yes

Visit Per Day

1

434

Occupational Therapy - Evaluation

Visit Per Day

1

G0161

440

Speech Therapy

Yes

Visit Per Day

1

G0162

550

Skilled nursing: Initial assessment/re- assessment

Yes

Visit Per Day

1

G0283

420

Physical Therapy

Yes

Visit Per Day

1

G0299

551

Skilled nursing: Treatment, teaching/training, observation/evaluation

Yes

Visit Per Day

1

559

Skilled nursing: For a dually eligible beneficiary when the visit does not meet Medicare criteria

Visit Per Day

1

580

Skilled nursing: venipuncture

Visit Per Day

1

581

Skilled nursing: Pre- filling insulin syringes/Medi- Planners

Visit Per Day

1

G0300

551

Skilled nursing: Treatment, teaching/training, observation/evaluation

Yes

Visit Per Day

1

559

Skilled nursing: For a dually eligible beneficiary when the visit does not meet Medicare criteria

Visit Per Day

1

580

Skilled nursing: venipuncture

Visit Per Day

1

581

Skilled nursing: Pre- filling insulin syringes/Medi- Planners

Visit Per Day

1

G0493

550

Skilled nursing: Initial assessment/re- assessment

No

Visit Per Day

1

G0494

550

Skilled nursing: Initial assessment/re- assessment

No

Visit Per Day

1

G0495

551

Skilled nursing: Treatment, teaching/training, observation/evaluation

No

Visit Per Day

1

559

Skilled nursing: For a dually eligible beneficiary when the visit does not meet Medicare criteria

Visit Per Day

1

G2168

420

Physical Therapy

Yes

Visit Per Day

1

G2169

430

Occupational Therapy

Yes

Visit Per Day

1

S9122

570

Home Health Aide Visit

Yes

Visit Per Day

1

S9123

551

Skilled nursing: Treatment, teaching/training, observation/evaluation

Yes

Visit Per Day

1

559

Skilled nursing: For a dually eligible beneficiary when the visit does not meet Medicare criteria

Visit Per Day

1

S9124 

551

Skilled nursing: Treatment, teaching/training, observation/evaluation

Yes

Visit Per Day

1

559

Skilled nursing: For a dually eligible beneficiary when the visit does not meet Medicare criteria

Visit Per Day

1

580

Skilled nursing: venipuncture

Visit Per Day

1

581

Skilled nursing: Pre- filling insulin syringes/Medi- Planners

Visit Per Day

1

S9128

440

Speech Therapy

Yes

Visit Per Day

1

S9129

430

Occupational Therapy

Yes

Visit Per Day

1

S9131

420

Physical Therapy

Yes

Visit Per Day

1

T1002

551

Skilled nursing: Treatment, teaching/training, observation/evaluation

Yes

Visit Per Day

1

559

Skilled nursing: For a dually eligible beneficiary when the visit does not meet Medicare criteria

Visit Per Day

1

T1021

570

Home Health Aide Visit

No

Visit Per Day

1

T1030

551

Nursing Care, In The Home, By Registered Nurse

Yes

Visit Per Day

1

* Visit Per Day - defined as 1 visit corresponds to 1 billed unit for each date of service within which the visit occurs

Member Attestation Codes

Code Description
MA1000 Complete
MA1005 Member Refused
MA1010 Member Unable
MA1015 No Signature (Other)


Manual Reasons Codes

Code Description
MR1000 Caregiver error
MR1005 No access to application or IVR
MR1010 Technical error
MR1015 Duplicates/overlapping
MR1020 Forgot to clock in/out
MR1025 Missing/waiting for authorization
MR1055 New agency using EVV


Late Reasons Codes

Code Description
LR1000 Caregiver forgot to check in
LR1005 Technical issue
LR1010 Member would not allow staff to use device
LR1015 Member rescheduled


Late Visit Actions Taken Codes

Code Description
LA1000 Rescheduled
LA1005 Back-up plan initiated
LA1010 Contacted service coordinator
LA1015 Contacted MCO member services
LA1020 Caregiver checked in late

 
Missed Reasons Codes

Code Description
MVR1000 Caregiver did not show up
MVR1005 Caregiver forgot to check in / out
MVR1010 Technical issue
MVR1015 Unplanned hospitalization
MVR1020 Authorization not in place at time of visit
MVR1025 Member or family refused service
MVR1030 Provider agency unable to staff
MVR1035 Member rescheduled
MVR1040 Scheduling Error


Missed Visit Actions Taken Codes

Code Description
MVA1000 Rescheduled
MVA1005 Back-up plan initiated
MVA1010 Contacted service coordinator
MVA1015 Contacted PHP member services
MVA1020 Service provided as scheduled

 

Visit Location Type Codes

Code Description
1 Home
2 Community


MCOID Codes

Code Description
NC_BCBS Healthy Blue of North Carolina

 

Care Plan Tasks

Code Category Task Description

10

Bathing / Personal Hygiene

Tub bath or shower

20

Bathing / Personal Hygiene

Upper body

30

Bathing / Personal Hygiene

Lower body

40

Bathing / Personal Hygiene

Tub/shower transfer/position

50

Bathing / Personal Hygiene

Bed bath

60

Bathing / Personal Hygiene

Sponge bath

70

Bathing / Personal Hygiene

Additional transfer (reposition in bed change occupied bed)

80

Bathing / Personal Hygiene

Shampoo/hair care

90

Bathing / Personal Hygiene

Skin care (includes wash face/hands foot care)

100

Bathing / Personal Hygiene

Nail care

110

Bathing / Personal Hygiene

Mouth/oral/denture care

120

Bathing / Personal Hygiene

Shave

130

Dressing

Don clothing/shoes/socks

140

Dressing

Remove clothing/shoes/socks

150

Dressing

Clothing and shoe fasteners

160

Dressing

Assist with TEDS

170

Dressing

Assist with braces/splints

180

Dressing

Assist with binders

190

Dressing

Assist with prosthetics

200

Mobility

Transfer to/from bedroom

210

 Mobility

Ambulation room to room

220

 Mobility

Assist with stairs

230

 Mobility

Passive/active ROM

240

 Mobility

Turn/reposition

250

 Toileting

Remove/pull up/fasten garments

260

 Toileting

Hygiene after toileting

270

 Toileting

Transfer to/from BSC or toilet

280

 Eating

Assist with cutting food

290

 Eating

Assist with feeding

300

 Eating

Assist with utensil usage

310

 Eating

Lift limb to mouth

320

 Eating

Tube feeding

330

 Eating

Clean meal service area

340

 Eating

Clean utensils/dishes

350

 Eating

Open packages

360

 Eating

Equipment set up and clean up

370

 Eating

Heat/assemble food

380

 Mobility

Transfer to/from chair

390

 Transfer

To/from bed

400

 Transfer

To/from chair

410

 Transfer

To/from toilet

420

 Transfer

To/from scooter

430

 Transfer

To/from stroller

440

 Transfer

To/from wheelchair

450

 Transfer

to/from vehicle

460

 Personal Hygiene

Shampoo/hair care

470

 Personal Hygiene

Skin care (includes wash face/hands

480

 Personal Hygiene

Make up

490

 Personal Hygiene

Nail care/trimming

500

 Personal Hygiene

Mouth/oral/denture care

510

 Personal Hygiene

Shaving

520

 Additional Tasks

Errands to assist with ADLs (CAP only)

530

 Additional Tasks

BP monitoring

540

 Additional Tasks

Blood glucose monitoring

550

 Additional Tasks

Medication self-administration reminders

560

 Additional Tasks

Break up and remove fecal impaction

570

 Additional Tasks

IV fluid assistive activities

580

 Additional Tasks

O2 therapy

590

 Additional Tasks

Ostomy care/irrigation

600

 Additional Tasks

Sterile dressing change (wound over 48 hours old)

610

 Additional Tasks

Suctioning, nasopharyngeal

620

 Additional Tasks

Suctioning, oropharyngeal

630

 Additional Tasks

Tracheostomy care

640

 Additional Tasks

Urinary catheterization/irrigation

650

 Additional Tasks

Wound irrigation

660

 Additional Tasks

Tube feeding and G-tube management

 

Survey/Observed Changes Question

Code Task Description

SQ1000

Did the member's health or illness worsen since your last visit?

SQ1005

Did you notice or were you told about any safety risks in the home today?

SQ1010

Does the member have any problems taking their medication?

SQ1015

Has the member been admitted to the hospital or emergency room since the last visit?

SQ1020

Has the member fallen since the last visit?

SQ1025

Is the member looking or acting different than they usually do?


Pre-Billing Validation

Pre-billing checks are performed in the CareBridge system to ensure that clean claims are generated and that EVV Data is valid.  If validation errors are present in response files or appointment error files, they must be resolved by the agency or vendor prior to claim generation.

 

A full list of CareBridge Pre-Billing Validations can be found under Technical Specifications for Third-Party Vendors>Pre-Billing Validations

 

 

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