CMS Updates Home Health Claims Processing Manual
June 27, 2014 09:21 AM
The Centers for Medicare & Medicaid Service issued Change Request (CR) 8775, which makes a variety of changes to Pub. 100-04, Medicare Claims Processing Manual. The changes to the manual are largely technical that fall into one of three categories. The manual updates do not make any changes to current claims processing policies.
Clarification to Home Health Consolidated Billing (HH CB) Instructions. In 2003, Change Request (CR) 2705 made changes to Medicare systems to bypass services from HH CB editing when provided by a physician. CR 2705 provided a list of physician specialty codes that are used in this bypass, but the list was never included in the Medicare Claims Processing Manual. This CR adds this list to the HH CB section of chapter 10. It also makes some wording clarifications to better reflect how Medicare system edits currently enforce HH CB. Finally, this CR adds a new section to chapter 20, directing suppliers affected by HH CB to chapter 10 for additional information.
Removal of References to the Home Health Advance Beneficiary Notice (HHABN). CR 8404 described the use of the Advance Beneficiary Notice of Non-coverage (ABN) as a replacement for the HH ABN. This CR makes conforming changes to chapter 10 to remove references to the HHABN.
Conforming to National Standards. This CR makes detail changes throughout many sections of chapter 10 to ensure that references to type of bill and revenue code values mirror the way these values are used in the National Uniform Billing Committee's Official UB-04 Data Specifications Manual. Additionally, one remittance advice code pair is updated to comply with CAQH CORE operating rules for code usage on remittance advices.
To view the CR, please click here.