Production Alert Details

Home Health 32G Adjustment Issue for Separation Periods of < 60 Days​​​​​​​

Date Reported:
Provider Types Impacted:

Part A Home Health providers in Jurisdiction 6 and Jurisdiction K

Reason Code(s):
Claim Coding Impact:

Description of Issue

A segment of home health claims with 32G type of bills are incorrectly being re-coded to earlier periods during processing, instead of the correct later periods. This error is occurring when the separation between the two periods is 60 days or less. Based on the PDGM, the first digit of the HIPPS code identifies the period as either early (digits 1 or 2) or later (digits 3 or 4). When the periods are adjacent, meaning they are separated by no more than a 60-day period, the HIPPS code should begin with 3 or 4.

National Government Services Action

All Medicare Administrative Contractors, including National Government Services, have reported this issue to the Centers for Medicare & Medicaid Services and a solution is being researched.

Provider Action

Please continue to monitor future Email Updates for additional updates

Proposed Resolution/Fix