Home Health & Hospice Week

Industry Note:

Get Site Of Service Codes Right Or Risk Claims Delays

Codes required on final claims only.

If you haven’t gotten your Q codes right on home health agency claims for episodes ending in the past month, your cash flow is suffering.

You can get your site of service facts straight with a new billing guide on the topic from HHH Medicare Administrative Contractor NHIC.

A no-no: "HCPCS site of service codes Q5001, Q5002, or Q5009 must be reported on HH PPS claims containing revenue code: 042X, 043X, 044X, 055X, 056X, or 057X or the claim will be returned to the provider," NHIC explains in the new guide. "The line item date of service of the line reporting Q5001, Q5002, or Q5009 must match the earliest dated HH visit line (revenue codes 042X, 043X, 044X, 055X, 056X, or 057X) on the claim or the claim will be returned to the provider."

Another no-no: "When more than one line on an HH PPS claim reports Q5001, Q5002, or Q5009, then the same HCPCS code must not be reported on consecutive dates or the claim will be returned to the provider," NHIC continues.

Tip: When the patient moves location — such as from home to an assisted living facility — you need to bill a Q code for the data of the first visit in that new location, NHIC explains.

But don’t give yourself extra work. Q codes are required only on final claims, reminds HHH MAC Palmetto GBA in a question-and-answer set from its July 16 Ask the Contractor Teleconference.

The guide is at www.medicarenhic.com/providers/pubs/HHSiteServiceGuide.pdf.

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