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Home Health & Hospice Week

Industry Notes:

Learn This New Billing Requirement Or Risk Returned Claims

Published on Tue Mar 15, 2011

Don't forget to include Type of Admission codes on your claims. "The Priority (Type) of Admission or Visit code is now required on all version 4010A1 institutional claims submitted or corrected via direct data entry, as well as on version 5010 institutional claims, regardless of how they are submitted," CMS explains in an e-mail message. Home care providers were confused when they started receiving returned claims with 11701 and 11801 error codes (see Eli's HCW, Vol. XX, No. 14, p. 111). Tip: "Providers that are unsure which code to use are to use code 9 (Information not Available)," CMS instructs. Outpatient claims were editing incorrectly with reason code 11701 and 11801, HHH MAC Palmetto GBA notes on its website. The new Type of Admission code requirement is for institutional claims only. But the issue is resolved and claims are  no longer rejecting in error, Palmetto says. CMS "directed contractors to [...]
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