Home Health & Hospice Week
Watch For Therapy-Related Recoupments In Coming Weeks
Watch for potential recoupments related to a therapy downcoding problem coming soon.
Problem: “Claims reporting Health Insurance Prospective Payment System (HIPPS) codes beginning with 5 are not being recoded correctly when fewer than 20 therapy services are provided. These errors affect only home health claims with receipt dates on or after October 1, 2015,” HHH MAC Palmetto GBA says on its website. They also affect only claims that resulted in overpayments, Palmetto adds.
Solution: “A resolution to this issue will be implemented January 4, 2016,” HHH MAC CGS says on its website. MACs “will make the necessary adjustments to claims/adjustments with receipt dates between 10/1/2015 and 1/4/2016 and a provider submitted HIPPS code of 5, and fewer than 20 occurrences of therapy visits (042x, 043x, and 044x). Home health agencies do not need to take any action.” CGS expects its adjustments to be completed within two months of Jan. 4, it adds.
Home Health & Hospice Week
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Watch For Therapy-Related Recoupments In Coming Weeks
Watch for potential recoupments related to a therapy downcoding problem coming soon. Problem: “Claims reporting [...] - Industry Note:
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