Production Alert Details

Home Health Claims Incorrectly Receiving Reason Code U538E

Date Reported:
10/17/2022
Date Updated:
01/24/2023
Date Resolved:
02/14/2023
Status:
Closed
Provider Types Impacted:

Part A home health providers in Jurisdiction K and Jurisdiction 6

Reason Code(s):
N/A
Claim Coding Impact:
N/A

Description of Issue

HH final and adjusted claims with 2022 dates of service are receiving U538E incorrectly, when there is an older period on file. This prevents providers from being able to adjust these claims and update patient status from “06” to any other patient status.

National Government Services Action

The CWF maintainer is aware of the issue and National Government Services is awaiting information on pending resolution.

Provider Action

Providers are advised to adjust impacted claims with condition code E0 and to change the patient status code back to the most appropriate code. Please watch for future Email Updates for additional information.

Proposed Resolution/Fix

2/14/2023