Medicare requires both prongs: the patient needs the aid of a supportive device or another person or has a condition that makes leaving home medically contraindicated, and leaving home requires a considerable and taxing effort. Document patient-specific evidence when homebound status is assessed, and ensure the longitudinal record continues to support both Medicare homebound criteria.
Evidence from this system that supports homebound status
A GI condition with severe symptoms or an ostomy requiring management that, with weakness, makes leaving home difficult without assistance.
Post-operative abdominal status or severe GI symptoms limiting safe mobility.
Weakness from poor intake or GI losses requiring assistance for safe mobility.
The considerable and taxing effort required to leave home given the GI condition.
Homebound paragraph — example
Patient remains homebound. A GI condition with associated symptoms and weakness, together with the management it requires, means the patient needs the assistance of another person and a device for safe mobility, and leaving the home is exhausting. Leaving home therefore requires a considerable and taxing effort.
