Update on Expanded Home Health, Hospice Denial Reason Codes
December 18, 2015 10:46 AM
The December 4 issue of NAHC Report included coverageof recent action by the Centers for Medicare & Medicaid Services (CMS) to expand the number of denial reason code statements available to the Medicare Administrative Contractors (MACs) for use in adjudicating home health and hospice claims. The home health and hospice MACs began using the expanded list of denial reason code statements effective December 1, 2015. At press time lists of the more than 80 detailed denial reason codes was not available; CGS, one of the home health and hospice MACs, recently posted the lists to its website; they are available here:
Home Health: http://www.cgsmedicare.com/hhh/medreview/hh_drc.html
CGS’ website further instructs that providers may access denial reason code definitions by accessing the denied claim using the Fiscal Intermediary Standard System (FISS) Claim Inquiry menu (Option 12), and pressing F1 to view the reason code narrative.