Home Health & Hospice Week

Don’t delay your NOA or RAP any further than necessary.

That’s the mistake a number of home health agencies are making, reports HHH Medicare Administrative Contractor Palmetto GBA. “Palmetto GBA has seen an increase of invalid late Home Health Notice of Admissions (NOAs) and Requests for Anticipated Payment (RAPs) exception requests,” the MAC says on its website.

For example: “HHAs are requesting late NOA or RAP exceptions when the NOA or RAP was received timely,” Palmetto relates. “This is done by applying the KX modifier and/or remarks unnecessarily on claims. This will cause the claim to suspend, delay its processing and the claim may be returned for correction.”

Another example: “HHAs are requesting late RAP exceptions on issues that affected NOAs only, or vice versa,” Palmetto reports. “For example, in early 2022 NOAs edited in error for Reason Code 19960, Condition Code other than 47. HHAs are submitting this issue as the reason a RAP was late, for home health claims with a ‘from’ prior to January 1, 2022. This processing issue affected NOAs only and is not valid for late RAPs. If this exception is requested on a RAP, the exception will be denied,” the MAC says.