Home Health & Hospice Week

Warning: Patient status codes are important.

The closer the implementation gets for the new home health Notices of Admission, the more details come out.

Reminder: NOAs will begin Jan. 1, notes Lynn Labarta with Imark Billing in Miami. Requests for Anticipated Payment “will be eliminated, and home health agencies will only need to submit a one-time Notice of Admission (NOA) effective for claims on and after January 1, 2022,” Labarta reviews.

The latest instructions from the Centers for Medicare & Medicaid Services are in Change Request 12424 released Sept. 10. “In cases where an HHA provides care in a 30-day period of care and then discharges the beneficiary in the next 30-day period of care, but does not provide any billable visits in the next 30-day period, special handling of the patient status code may be needed,” CMS advises providers.

Normally, the patient status code for a 30-day period before the discharge would be 30, since the beneficiary has not yet been discharged, CMS explains. “However, since there will not be a claim for the period in which the discharge occurred, this would result in the HH admission period remaining open in Medicare systems and prevent billing for any later HH services,” the transmittal outlines.

Do this: “In order to close the HH admission period in these cases, the HHA should report patient status 01 on the claim for the last 30-day period in which visits occurred,” CMS instructs. “This will trigger Medicare systems to close the HH admission period.”

And this: “If the claim has been submitted with patient status 30 before the discharge occurred, the HHA should adjust the claim to change the patient status to 01,” CMS adds.

But not this: “If the cause of the discharge in the next 30-day period is a transfer to another HHA before any visits were provided, the HHA should take care not to report patient status 06 on the claim,” CMS continues (emphasis added). “This would result in an incorrect partial period payment adjustment.”

Or this: “If the cause of the discharge in the next 30-day period is the beneficiary’s death, the HHA should take care not to report patient status 20 on the claim,” CMS tells providers. “This would result in an incorrect date of death being recorded in Medicare systems and potentially affect claims from other providers.”

Note: The 18-page transmittal is at www.cms.gov/files/document/r10987cp.pdf.