Home Health & Hospice Week

If your final claim gets rejected with reason code C7080

If your final claim gets rejected with reason code C7080, don't just submit another request for anticipated payment for the episode -- that only makes the problem worse, says regional home health intermediary Cahaba GBA in an email message to providers.

Claims reject with reason code C7080 because of overlapping inpatient stays, Cahaba explains. "Submitting a second RAP in this situation creates additional billing errors," the intermediary warns. "These may, in turn, impact the provider's ability to submit their Medicare claims timely, as this is a provider billing error and not a system issue."

Instead: "The HHA should verify ... the rejected claim information posted to the Common Working File (CWF) by reviewing the TPE-TOTPE (Tape to Tape) field on MAP171D in FISS," Cahaba instructs. "If this field is blank, the information from the rejected claim posted to CWF, and should be adjusted to remove the overlapping date(s) of service."

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