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Date Mix-Ups Torpedo PPS Claims

COLUMBIA, SC (Home Care Wire) You could prevent holdups to your cash flow by avoiding simple date problems.

 

Four of home health agencies’ top submission errors involve incorrect dates on claims, says regional home health intermediary Palmetto GBA in its new review of the top 10 submission errors from October 2007.

 

Reason code 31755 occurs when the From, Thru and 0023 line item dates don’t agree. For example, if the From and Thru date are the same, the 0023 date must also match, Palmetto explains.

 

Reason code 31018 shows up when your claim tries to make the patient’s prospective payment system episode greater than 60 days. You can verify the episode dates through HIQH, Palmetto advises.

 

HHAs receive reason code U5386 when the line item date doesn’t fall within the 60-day episode. This is often due to a canceled request for anticipated payment (RAP), the intermediary points out.

 

Reason code 32907 is a similar problem, noting the requirement for line item services to fall within the 60-day period. Other top submission errors included trying to submit final claims when no RAPs for the episodes exist (38107); the now-defunct M0175-related incorrect HIPPS code based on prior inpatient stay (C727); incorrect beneficiary information (T5052 and N5052) and missing units for required revenue codes (32226).

 

For more on the top submission errors and ways to avoid or solve them, see www.palmettogba.com.


Apr 25, 2008, 10:07

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