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Home Health & Hospice Week

Industry Note:

Sidestep This Little Known HIPAA Claims Mistake

Published on Fri Jan 20, 2012

Be sure the "Total Charges" field on your claims is filled out, or you could be risking HIPAA violations. Old way: "Medicare's instructions since 2000 have stated that the (SV203) field may be zero or blank," CMS explains in a new MLN Matters article based on Dec. 22 Transmittal No. 2374 (CR 7660). New way: "CMS recently discovered that Medicare's instruction regarding the reporting of the Total Charges field on claims is in conflict with the requirements of the HIPAA standard 837 Institutional claim format," the agency explains in the article. "The 837 requires that the Total Charges field (SV203) must always be reported, and that zero is an acceptable value." The transmittal and article also clarify how to demand bill when requests by the state Medicaid program do not correspond to dates of existing episodes of care. The transmittal is at www.cms.gov/transmittals/downloads/R2374CP.pdf and the article is at
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