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Home Health & Hospice Week

Coding Snafu Causes Payment Delays.

Published on Wed Sep 15, 2010

• A payment system glitch based on diagnosis codes may be hanging up your claims for patients with spinal, pain, and other problems. "Some ICD-9-CM diagnosis codes do not have a valid record set up in the Fiscal Intermediary Standard System (FISS) for the period from 10/1/ 2009 to 9/30/2010," explains RHHI Cahaba GBA in a message to providers. "Claims with dates of  service on or after 10/1/2009 to 9/30/2010 are either going to the Return to Provider (RTP) file (if the claim is entered via Direct Data Entry (DDE)), or being rejected on the Audit Report (if submitted electronically)," the intermediary says. So far, Medicare has found these codes trigger the problem, Cahaba says: 72402, 64630, 64631, 78900, 78650, and V078. Stay tuned: "Additional research is necessary," the RHHI tells agencies. "Cahaba will provide additional information as soon as it becomes available."
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