Home Health & Hospice Week

Don’t let billing confusion about no-pay claims lead to cash flow problems.

The problem: “CGS has seen instances where no-payment claims are being submitted with the incorrect type of bill (TOB) 0329,” the HHH Medicare Administrative Contractor says in a message to providers. “No-payment claims are submitted to seek denials for the entire claim in cases where you know all services will not be covered by Medicare. Such denials allow providers to obtain a denial notice from Medicare for other payer consideration.”

The solution: “A no-payment claim must be submitted with the 0320 TOB and condition code 21,” CGS instructs. “Submitting an incorrect TOB will apply an incorrect denial reason code to the claim and may cause claim processing delays.”

Check out CGS’s webpage about billing with condition code 21 at www.cgsmedicare.com/hhh/education/materials/hh_nopay_billing.html.