Home Health & Hospice Week
Beware Adjustments For Physicians Missing From PECOS
If you’ve seen an uptick in claims adjustments, a claims system error may be to blame. “From October 1, 2018, through April 22, 2019, the home health ordering/referring/attending physician reason code 32072 was not editing correctly,” HHH Medicare Administrative Contractor Palmetto GBA says in a new post on its website. “This allowed claims containing a terminated attending physician to incorrectly pay. These claims should have denied.” A fix installed in May adjusted more claims than it should have, although the claims were adjusted properly, Palmetto explains. Claims were either denied for the terminated physician, were “adjusted” in error (but the adjustment didn’t actually change the payment amount), or are pending due to other reason codes. Palmetto will adjust the pending claims in June, it says.
Home Health & Hospice Week
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