Home Health & Hospice Week
Watch For These Claims Adjustments
Mysterious underpayment corrections may be due to a fix HHH Medicare Administrative Contractor Palmetto GBA announced last month.
The system incorrectly underpaid claims under the CWF edit U539Z, due to the Ambulatory Payment Classification (APC) rate not being zeroed out prior to calling Pricer, Palmetto explains on its website. Now that a fix went in on Feb. 6, the MAC will reprice the claims using the Medicare Physician Fee Schedule (MPFS).
To receive the mass adjustment, a claim must be Type of Bill 34x and have: a FROM date on or after 01/01/2017; a process date on or after 01/03/2017 and up to 02/06/2017; Revenue Codes 042x or 043x; CPT Codes 97607 or 97608 and; a Re-price Indicator of “Y”, Palmetto says on its website. The MAC will complete the adjustments within 90 calendar days, Palmetto said in a Feb. 13 post.
Home Health & Hospice Week
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