January 2008 Top Home Health Claims Submission Errors

HIQA for exact spelling of name and Jr/Sr information.
Make necessary corrections and F9 claim.
It may be necessary to contact the beneficiary for further verification.
31755This reason code will be assigned if Home Health type of bill 3x2 or 3x9 is entered and the following criteria is not a match:

If the admission date of the claim is equal to the statement from date, the earliest 0023 line date should also be equal;
The From and Thru Dates and Admission Date on the RAP are the same. Therefore, the 0023 line item Service Date must also match.

OR
The Final Claim does not have a visit that corresponds to the date shown on the 0023 line item Service Date (the first billable visit).

OR

The RAP is missing the revenue code 0023 and line item Service Date.

Review the RTP'd RAP in the Direct Data Entry (DDE) system.

• Does the Statement From and Thru Date (Field 6) match the Admission Date (Field 17)? If yes, select 03 Corrections in DDE, access the RAP and change the 0023 line item Service Date (Field 45) to the same date, F9 the claim.
• If 0023 line item Service Date is missing from the claim, it can be added and then F9 the claim.

Is there a visit on the final claim that matches the 0023 line item service date? If no, verify that the 0023 line item service date is correct (first billable visit). Select 03 Corrections in DDE, access RTP'd claim and add visit to the final claim, and correct total charges. If 0023 line item service date on the RAP is incorrect: Cancel the processed RAP. Once the processed RAP is canceled, resubmit a new RAP. 32038Claim is type of bill 32X or 33X with service dates of 10/01/97 or greater, and provider fiscal start date is equal to 10/01/97 or greater, a Value Code 61 is present with a Value Code amount (MSA code) that contains more than 4 positions (not including the decimal places) that represent the MSA code but the MSA code is either invalid or is not present on the MSA table.***

For claims with service through dates 01/01/06 or greater, a Value Code 61 is present with a Value Code amount that contains more than 5 positions (not including the decimal places) that represent the CBSA code but the CBSA code is either invalid or is not present on the CBSA table. The claim bill type is equal to 32X OR 33X with date of service of 100197 or greater. Value code 61 is present with a value code amount that is either invalid or not present on the MSA Table.

Please correct and resubmit hardcopy. Submittors resubmit RTP report with corrections.

*****For Claims with service through dates of 010106 or greater, a Value code of 61 is present with a Value Code Amount (CBSA CODE) but the CBSA code is 1) either invalid or is not present on the CBSA table.

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