Home Health & Hospice Week

Zip code glitch still waiting on fix.

Winter weather isn’t the only sloppy thing going on in January. Issues with submission and acceptance of the new home health Notices of Admission continue.

“We’re seeing three main challenges with NOAs,” says Michael Greenlee, founder and CEO of billing and coding firm HealthRev Partners in Ozark, Missouri. “First, many [electronic health record systems] were not ready to comply with the new requirements,” Greenlee tells AAPC.

“This is forcing agencies to manually enter NOA data directly into the DDE system to avoid late submissions and penalties,” Greenlee explains. “This is also forcing agencies to manually track due dates and submission dates to make sure that they don’t miss anything.”

The second issue is HHH Medicare Administrative Contractor problems, which the MACs have posted to their claims processing logs. For example, for “home health bill type 32A,” aka NOAs, “an issue with ZIP codes submitted on EMC claims has been identified for all Medicare Administrative Contractors, causing it to incorrectly return to provider with reason code 32114,” MAC National Government Services reports on its website.

A fix is scheduled for Feb. 2. Until then, “providers are advised to add the required ZIP code to affected claims and to resubmit those claims for processing,” NGS says.

HHH Palmetto GBA reported another issue on Jan. 18.

Problem: For “NOAs that were held for the January 2022 System Release … the system add[ed] Condition Code 15 to the NOA, causing them to Return to Provider,” the MAC says.

Solution: “For most NOAs affected by this issue, Palmetto GBA was able to remove Condition Code 15 and reason code 19960 prior to the NOA returning to the provider (Status/Location TB9900), which will allow the NOA to process without returning to the provider for this issue and affecting the received date,” the MAC says. “However, some NOAs may complete returning to provider (Status/Location TB9997). Palmetto GBA is reviewing these NOAs for resolution and will provide an update when available,” it says.

Last is missing data, Greenlee relates. “For example, agencies must include the four-digit routing code at the end of a zip code,” he points out.

“This is all causing extra work and headaches for agencies,” Greenlee reports. “And if they don’t stay on top of it, it puts them at risk,” he warns.

Remember, after the five-day deadline, you are docked 1/30 of the billing period reimbursement for every day the NOA is late beginning at the start of care visit.

Some NOA progress exists, however. “We do have NOAs in a paid status for CGS,” reports billing expert M. Aaron Little with BKD in Springfield, Missouri. At least that’s one HHH MAC.

“In some regard things are smoothing a bit, but issues continue to persist,” Little tells AAPC.