Home Health & Hospice Week

Get up to speed on deleting and restoring Revenue Code lines.

It may be good news that your claims with no matching OASIS now return to you instead of denying outright, but that doesn't help if you can't get the claims to process again once you've corrected the errors causing the problem.

Problem: "When providers use the F9 function to resubmit claims after taking the necessary actions ... the claim returns to the RTP file with 37253," HHH Medicare Administrative Contractor CGS says on its website. "Providers will need to take an extra step to allow the claim to process."

Remember, you can only secure payment if there actually was an OASIS in the system when you submitted your claim. But if there's an error with the HIC number or assessment completion date, you can fix it and the claim will process (see Eli's HCW, Vol. XXVI, No. 37).

Solution: "When the claim goes to RTP with reason code 37253, the Fiscal Intermediary Standard System (FISS) adds 'ZZZZZ' in the HIPPS1 and HIPPS2 fields on MAP171E," CGS explains. "The information in these fields needs to be removed to continue processing; however, providers are unable to access these fields. In order to remove this information, providers will need to delete the 0023 revenue code line, and then rekey the same 0023 revenue code line information," the MAC instructs.

Tip: To delete the 0023 revenue code line, you must key the letter "D" in the first position of the 0023 revenue code; press the HOME key on your keyboard so that your cursor is placed in the upper right hand corner of the screen (the "Page" field); and press Enter. "The revenue code line(s) with the letter 'D' will be removed, and FISS will automatically reorder the remaining revenue code lines," CGS explains.

To add the 0023 revenue code line, you must re-key the same 0023 revenue code line information that was deleted under the 0001 revenue code line; press the HOME key on your keyboard; and press Enter. "FISS will automatically reorder the revenue code lines," CGS says.

Finally, press F9 to allow the claim to continue processing, CGS concludes.