Production Alert Details

Home Health Claims Returned to Providers with Reason Code 31755​​​​​​​

Date Reported:
Provider Types Impacted:

Jurisdiction 6 and Jurisdiction K Part A Home Health Providers

Reason Code(s):
Claim Coding Impact:

Description of Issue

CMS reactivated RC 31755 effective 1/3/2023 and some HH claims are being RTP due to billing errors. These claims need to be corrected with the information provided in the Provider Action section of this article. Medicare is still is receiving claims for January 2022 that used an artificial admission date, causing the claims to RTP with RC 31755. These claims are being researched to determine what action is required.

National Government Services Action

National Government Services is researching possible solutions to this issue.

Provider Action

Providers are advised to enter the date of the first covered visit during the period with Revenue Code 0023. For subsequent periods, providers are advised to report the date of the first visit during the period, regardless of whether the visit was covered or noncovered.

Some of the returned claims are reporting the first day of the period rather than the first visit date; these may be corrected and resubmitted.

Proposed Resolution/Fix