Eli's Hospice Insider
Claims System Glitch Derails Hospice Payments
HHH Medicare Administrative Contractor CGS has turned off Reason Code 32061 that was inappropriately holding up hospice and HHA payments from Medicare, but you may need to take some extra steps to get your rightful reimbursement.
Background: Claims were incorrectly returned with the Reason Code last month. “This reason code indicates that a split claim is required on all non-PPS bills when the TO date on the claim overlaps the fiscal year end of the provider,” CGS explains.
“CGS has released the claims that were in the returned to the provider (RTPd) inappropriately,” the MAC says. “However, some hospice claims (types of bill 81X and 82X) and home health (type of bill 34X) claims may still appear in the RTP file with reason code 32061.”
Take action: “Providers should be aware that they need to F9 any remaining claims in the RTP status/location (T B9997) with reason code 32061,” CGS explains.
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