Home Health & Hospice Week
Nursing G Code Glitch Returns Claims In Error
A Medicare payment system glitch related to the four new nursing G codes that took effect Jan. 1 is slowing home health agencies’ reimbursement.
The problem: “Reason code 32403 is being received incorrectly on claims when HCPCS code G0163 and G0164 are reported with a line item date of service prior to January 1, 2017,” CGS reports on its website. The problem appears on claims that span 2016 and 2017 dates of service. “At this time, these claims appear in status/location S MFEES, or in the Return to Provider file at T B9997.” Palmetto GBA also reported such claims RTPing.
“HCPCS G0163 and G0164 were retired and are no longer valid for services on or after 1/1/2017,” CGS points out (see Eli’s HCW, Vol. XXV, No. 43). “However, they are valid for line item service dates prior to 1/1/2017.”
The solution: “Palmetto GBA has updated the HCPC files to allow these codes to process for line item dates of service prior to January 1, 2017,” the MAC says on its website. “Home health agencies can now ‘F9’ any claims that were incorrectly returned.”
But CGS hasn’t issued such a message yet, so agencies served by that MAC should hold tight.
Home Health & Hospice Week
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