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Home Health & Hospice Week

Industry Note:

Incorrect G Code Adjustments, National Provider Identifier Suspensions Hound Home Care Providers

Published on Wed Sep 21, 2011

A few different claims system glitches might have held up your claims, but those problems soon should be resolved without any effort on your part. Problem #1: "New billing transactions were incorrectly generating adjustments automaticallywith a 'G' as the third digit of the type of bill," HHH MAC CGS says in a message to providers. Because the system was automatically generating the adjustments, Requests for Anticipated Payment (RAPs) couldn't be adjusted," HHH MAC Palmetto GBA explains. The FISS contractor fixed the problem, but the MACs now have to identify and inactivate the G adjustments, they say. CGS will move the inactivated adjustments to status/location I B9997, it says. Palmetto GBA will suspend the claims to a manual location, SM9009, then inactivate them. CGS expects the correction process to take up to two weeks, it says. In the meantime, "the original claims should continue processing." Problem #2: Some claims have suspended [...]
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