Home Health & Hospice Week

Plus: A centralized billing goof could doom your reimbursement.

Knowing what not to do is just as important as knowing what to do when it comes to submitting home health NOAs.

Take a look at the circumstances that do not qualify for an Notice of Admission late filing exception, according to HHH Medicare Administrative Contractors Palmetto GBA and CGS says in recently posted NOA articles. When the HHA:

— made no attempt to submit the NOA timely and did not meet any of the four circumstances that may qualify for an exception;

— can correct the NOA without waiting for Medicare systems actions;

— submits a partial NOA to fulfill the timely-filing requirement; or

— with multiple provider identifiers submits the identifier of a location that did not actually provide the service.

And make sure you know the reasons not to cancel an NOA:

— Change in the principal diagnosis code. “The principal diagnosis code reported on the NOA does not need to match the principal diagnosis reported on the initial period of care claim” except for NOAs submitted via 837I format, Palmetto and CGS say. And secondary diagnoses are not required on an NOA, they add.

— Change of physician/practitioner. You can just “report correct physician/practitioner on the claim(s),” Palmetto and CGS instruct.

— HIPPS code mismatch. “The HIPPS is not required on the NOA unless submitting via the 837I format, in which case HIPPS code ‘1AA11’ is used,” the MACs advise. “Since the field where the HIPPS code is submitted is not a required field on the NOA, there is not a matching field requirement for the NOA/period of care claim.” You can report any valid HIPPS code, they advice.

Note: The MAC NOA articles are at www.palmettogba.com/palmetto/jmhhh.nsf/DID/1FXR0VW8RN, www.cgsmedicare.com/hhh/pubs/news/2022/12/cope3767.html, and www.ngsmedicare.com/web/ngs/news-article-details?selectedArticleId=5098001.