Rx2000
Institute
11824 Wayzata Blvd
Minneapolis, MN 55305
Phone: 952-595-9551
FAX: 952-513-1544
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GovLink
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The Health Care Financing Administration (HCFA) has
identified an error in the billing information available in our "Home
Health Prospective Payment System Training Session" that is available
on the Medlearn website (www.hcfa.gov/medlearn/refhha.htm).
Page 33 of Chapter Four of these training materials contains an error
regarding the reporting of patient status codes in FL 22 of the UB-92
claim form. Currently, page 33 states:
"Enter the appropriate patient status code. If the beneficiary was
discharged prior to the end of the 60-day episode, enter a patient status
code of 06. If you are entering a patient status code of 20, note
that the statement through date on the claim must be the date of
death."
This entry should read:
"Enter the appropriate patient status code. If the beneficiary was
discharged prior to the end of the 60-day episode and the goals of the
plan of care are met, use patient status code of 01. Patient status code
06 should be used on a final claim when the beneficiary has transferred
from one agency to another HHA within an episode or when the patient is
discharged prior to the end of the 60-day episode and the HHA knows the
patient will be readmitted within the same 60-day period. If you are
entering a patient status code of 20, note that the statement through date
on the claim must be the date of death."
HCFA regrets this error and will be correcting the Medlearn site as soon
as possible.
HHA's may have submitted claims which ended prior to the end of the
60-day episode coded with a patient status code of 06 in situations which
were not transfers or discharges/readmissions. These claims will have
received Partial Episode Payment (PEP) adjustments in error, reducing
payments to the HHA. HHA's who discover this has occurred should submit
adjustments (type of bill 3x7) to their claims, changing the patient
status code to 01, in order to receive the balance of payment due for the
episode.
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