Home Health & Hospice Week

Industry Note:

Prevent 38157 Rejections With Some Education

Stop clogging up the Medicare claims payment system with duplicate RAPs, one HHH Medicare Administrative Contractor says.

Problem: From January to March 2017, “16,533 RAPs were rejected with reason code 38157,” MAC CGS says on its website. A RAP rejects “as a duplicate submission with reason code 38157 when the Fiscal Intermediary Standard System (FISS) identifies a RAP that has already processed,” the MAC explains. It appears that home health agencies often resubmit a RAP unnecessarily when a final claim rejects.

The solution: “If your final claim is rejected, it is not necessary for you to resubmit your RAP,” CGS instructs. “You can simply submit an adjustment (type of bill 327) to the final claim.” More pointers for the problem are at www.cgsmedicare.com/hhh/education/materials/38031_38157_38200.html.

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