Home Health & Hospice Week

Watch out for recoding to earlier periods.

As if regular billing isn’t enough to keep home health agencies busy, a new claims processing snafu has popped up to make life even harder.

The problem: “A segment of home health claims with 32G type of bills are incorrectly being re-coded to earlier periods during processing, instead of the correct later periods,” reports HHH Medicare Administrative Contractor National Government Services. “This error is occurring when the separation between the two periods is 60 days or less,” NGS says.

As a reminder, under the Patient-Driven Groupings Model, “the first digit of the Health Insurance Prospective Payment System (HIPPS) code identifies the period as either early (digits 1 or 2) or later (digits 3 or 4),” NGS explains. “When the periods are adjacent, meaning they are separated by no more than a 60-day period, the HIPPS code should begin with 3 or 4.”

The solution: NGS asks HHAs to sit tight while “a solution is being researched.”