Home Health & Hospice Week

Industry Notes:

Resolution Of C5467 Returned Claims Requires Action On Your Part, MAC Instructs

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.

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