If you’ve been sitting on claims that returned in error for Reason Code C5467, it’s time to resubmit them. Problem: For home health agencies in Review Choice Demonstration states, “HHAs that selected the pre-claim review (PCR) option have reported claims that have RTP for reason code C5467, requiring a UTN to be present on the claim, but have opted not to submit PCR request during the COVID-19 RCD pause,” HHH Medicare Administrative Contractor Palmetto GBA said on its website last month. “During this pause, HHAs have the option to submit a PCR request.” That option is about to come to an end (see story, p. 226).
Solution: “This issue is resolved. HHAs that had claims RTP in error for reason code C5467, may now return them for processing,” Palmetto says.