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NGSMedicare.com for home health + hospice providers

Medicare home health providers bring a wide array of skilled services directly to a patient’s residence to meet the needs of beneficiaries who are homebound. 

Medicare hospice agencies are dedicated to providing the highest level of comfort and care to beneficiaries diagnosed with terminal illnesses.

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Go to All News Articles

MLN Connects® Newsletter for Thursday, July 29, 2021

Posted Jul 29, 2021


LCD and Associated Billing and Coding Article Updates for July/August 2021

Posted Jul 23, 2021


MLN Connects® Newsletter for Thursday, July 22, 2021

Posted Jul 22, 2021


Correct Coding of Molecular Testing Panels

Posted Jul 22, 2021


MLN Connects® Special Edition for Monday, July 19, 2021

Posted Jul 20, 2021

Go to All Production Alerts

Part A Home Health Claims Suspending with Reason Codes 39910 and E0419



Date Reported

7/28/21

Status

Open

Provider Type(s) Impacted

Jurisdiction K and Jurisdiction 6 Part A HH Providers

Date Resolved

Reason Code(s)

39910 and E0419

Claim Coding Impact

N/A

Description of Issue

HH final claims that should take a full reduction (because RAP receipt date is greater than 30 days from the FROM date on the claims) are not populating value codes, but they do have the QF value code. This is causing claims suspensions with Reason Codes 39910 and E0419.

National Government Services Action

NGS is working with other HH MACs and the CMS to identify an appropriate solution to this problem.


Provider Action

No provider action is necessary at this time, however, please continue to check the Production Alerts section of our website and future Email Updates.

Proposed Resolution/Fix

TBD

Home Health: Penalty for RAPs Received More Than five Days Early


Date Reported

2/24/21

Status

Closed

Provider Type(s) Impacted

Home Health Agencies

Date Resolved

7/6/21

Reason Code(s)

N/A

Claim Coding Impact

N/A

Description of Issue

The Home Health Pricer program is incorrectly applying a penalty to RAPs received more than five days earlier than the “From” date of the RAP. The associated claims cannot be readily identified for MAC suspension.

National Government Services Action

System fix implemented 7/6/2021

Provider Action

Agencies may still submit RAPs as they choose.

Proposed Resolution/Fix

System fix implemented 7/6/2021; National Government Services adjusted claims with a value code QF amount greater than $0 (penalty amount) and a RAP RECEIPT DT of more than five days earlier than the “From” date.

HH+H LUPA Claims Rejection Error- Reason Codes 39929 and 37363


Date Reported

4/7/21

Status

Open

Provider Type(s) Impacted

J6 and JK HH+H providers

Date Resolved

Reason Code(s)

39929 (claim level) and 37363 (line level)

Claim Coding Impact

N/A

Description of Issue

LUPA claims are rejecting in error with RCs 39929 (claim level) and 37363 (line level), indicating incorrectly that RAP claims have been submitted beyond timeliness limits.



National Government Services Action

Update: 6/8/2021: Mass adjustments are complete.

Update: 4/21/2021: A workaround has been applied and claims will no longer deny at the claim or line level before final processing.


Provider Action

No provider action is needed, however, please continue to monitor the Production Alerts section of our website and future Email Updates.

Proposed Resolution/Fix

Approximately 10/4/2021

Go to All Upcoming Education

Jul 29

12:30 PM – 1:30 PM EDT
Hospice General Inpatient Documentation

Jul 29

1:00 PM – 3:00 PM EDT
Rescheduled: Medicare Secondary Payer Claims That Have Returned to the Provider

Jul 29

2:00 PM – 3:30 PM EDT
Part A July 2021 CMS Quarterly Update

Aug 3

10:00 AM – 11:00 AM EDT
Provider Enrollment Revalidation Overview

Aug 5

10:00 AM – 11:00 AM EDT
Provider Enrollment: Getting Access to PECOS
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