Home Health & Hospice Week

Prospective Payment System:

GET READY FOR NEW SUPPLIES EDIT IN OCTOBER

CMS puts limits on how you can change NRS digit on final claims. A new Medicare edit for nonroutine supplies shouldn't wreak havoc with your claims - if you know the NRS billing ropes. The Centers for Medicare & Medicaid Services is putting a new claims edit into place starting Oct. 5 for prospective payment system episodes dated Jan. 1, 2008 or later, according toApril 24 Transmittal No. 6393 (CR 1714). Under the edit, theMedicare claims system will allow home health agencies to change the fifth digit of the HIPPS code, which represents the NRS level, only from a number to its corresponding-NRS-level letter or vice versa. When PPS refinements instituting NRS payments took effect in January 2008, CMS lifted the requirement that the HIPPS code's fifth digit match on the request for anticipated payment (RAP) and final claim. That's so agencies could record that they provided no supplies when they [...]
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