Home Health Billing

Billing the Home Health Notice of Admission Electronically

Table of Contents

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Billing the Home Health Notice of Admission Electronically

Any codes within this job aid indicate common codes for required fields on Home Health NOAs. The NUBC maintains the coding information for Medicare billing, including the UB-04 data elements. For an all-inclusive listing of codes appropriate for all claim fields used for Medicare billing, visit the NUBC website to subscribe to the Official UB-04 Data Specifications Manual.

The bolded fields on the claim screen shots provided are the fields required when billing the Home Health NOA via the 837I format (electronically). The tables below the screen shots include field title descriptions and the associated valid values.

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NOA Claim Page 1

NOA Claim Page 1
 

Field Description/Notes
MID
Medicare ID Number
Enter the Medicare Beneficiary Identifier
TOB
Type of Bill
32A – Notice of Admission
32D – Cancellation of Admission
NPI
National Provider Identifier Number
Enter your home health agency’s NPI number.
STMT DATES FROM and TO (Statement Covers Period "From and "Through") Report the date of the first visit provided in the admission as the From date. The To or Through date on the NOA must always match the From date.
LAST, FIRST, MI, ADDR, DOB, SEX Patient’s last name, first name, and middle initial (if applicable), full address, date of birth (MMDDYYYY) and sex code (M/F)
ADMIT DATE Enter the effective date of admission, which is the first Medicare billable visit and the Medicare start of care date (MMDDYY). The Admission date on the NOA must always match the From date.
SRC
Source of Admission
Submit a default value of "1."
STAT
Patient Status
Submit default value of "30".
COND CODES
Condition Codes
Enter condition code 47 for a patient transferred from another HHA.
HHAs can also use cc 47 when the patient has been discharged from another HHA, but the discharge claim has not been submitted or processed at the time of the new admission.
FAC. ZIP Facility ZIP Code of the provider or subpart (9 digit code).

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NOA Claim Page 2

NOA Claim Page 2
 

Field Description/Notes
REV
Revenue Codes
Enter Revenue Code 0023, which indicates billing under HH PPS.
HCPC
Healthcare Common Procedure Code
Submit HIPPS code 1AA11 as a placeholder value, since differing HIPPS codes may apply over the course of an HH admission.
TOT UNITS
Total Services Units
Enter 1 unit
TOT CHARGE
Total Charge
The total charge for the 0023 revenue line must be zero.
SERV DT
Service Date
Must not be a future date. The admission date may be duplicated to satisfy this requirement.

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NOA Claim Page 3

NOA Claim Page 3
 

Field Description/Notes
PAYER
Payer Identification
Enter “Medicare” on line A with payer code “Z.”
RI
Release of Information
Enter “Y”, “R” or ‘’N”
“Y” – Indicates the HHA has a signed statement on file permitting it to release data to other organizations in order to adjudicate claims
“R” – Indicates the release is limited or restricted
“N” – Indicates no release is on file
DIAGNOSIS CODES Enter the appropriate ICD code for the principal diagnosis code or submit any valid diagnosis code.
ATT PHYS
Attending Physician
Enter the NPI and name (last name, first name, middle initial) of the attending physician who established the plan of care with verbal orders – this must be the individual physician’s NPI, not a group NPI.

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NOA Claim Page 4

NOA Claim Page 4
 

Field Description/Notes
REMARKS Remarks are not required on the NOA; however, remarks are recommended when canceling the NOA to indicate the reason for cancellation.

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NOA Claim Page 5

NOA Claim page 5
 

Field Description/Notes
INSURED NAME Enter the patient’s name as shown on the Medicare card.
CERT/SSN/HIC Enter the beneficiary’s Medicare number as it appears on the Medicare card if it does not automatically populate.

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Notes:

  • Required for any period of care that starts on or after 1/1/2022
  • HHAs with periods of care that continue into 2022 from 2021 need to submit an NOA with a one-time artificial admission date that corresponds with the ‘From’ of the new period of care in 2022
  • HHAs are to submit the NOA when they have received the appropriate physician’s written or verbal order that contains the services required for an initial visit, and the HHA has conducted the initial visit at the start of care
  • NOA must be submitted within five calendar days from the start of care. A payment reduction applies if an HHA does not submit the NOA within this timeframe.
    • Reduction in payment amount would be equal to a 1/30th reduction to the wage-adjusted 30-day period payment amount for each day from the home health start of care date until the date the HHA submitted the NOA

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Patients Continuing Care in 2022

HHAs with periods of care that continue from 2021 into 2022 must submit a NOA with a one-time artificial admission date that corresponds with the “From” on the new period of care in 2022.

For example, if the start of care is 12/13/2021, the first 30-day period of care runs from 12/13/2021 – 01/11/2022. The NOA date needs to be 1/12/2022 for the new period beginning in CY2022.

  • The reduction would include any outlier payment
  • The reduction amount will be displayed with value code QF on the claim
  • Start of Care: 12/13/2021
  • 30-day period of care: 12/13/2021 – 1/11/2022
  • Submit an NOA with an admission date of 1/12/2022 for the next 30-day period of care, and any subsequent period(s) of care until the patient is discharged

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Posted 1/13/2022