February 2008 Top Home Health Claims Submission Errors

in the system control file and the billing provider NPI is not present on the claim.

*will not assign when the demo code is '31'.The receipt date of the claim is on or after the NPI The implementation date in the system control file and the billing provider NPI is not present on the claim.32403According to the revenue code table, a HCPC is required for the line item being edited; however, the statement coverage dates on the claim fall outside of the effective/termination dates for the HCPC on the HCPC table file, so the HCPC was not valid during the statement coverage period.
this edit is bypassed when:
- HH TOB 32X or 33X
- statement from date >= 01/01/2007 and < 01/01/2008
- statement to date >= 01/01/2008
- valid 2007 HIPPS code (haej1 - hdim8)
HIPPS code dos <= HIPPS code term dateThis claim has been returned because a HCPCS code has been reported in Form Locator 50 which is not valid. The HCPCS Code is invalid because the service date reported in Form Locator 22 is prior to the date the HCPCS Code became effective, or, is on or after the date the HCPCS Code was deleted from the list of valid codes. Please correct and resubmit/rekey the hardcopy submitters' resubmit RTP Report with corrections (I.E. Outpatient Claim with DOS 01/01/92 or after With HCPCS 90000, or DOS before 10/16/91 With HCPCS Q0086, or DOS 03/01/91 or after With HCPCS 80067).* 31018Standard narrative: effective 10/01/00 -this reason code is assigned for home health type of bills 329 and 339. The statement thru date must not be greater than 60 days after the from date.
-or-
If the patient status is equal to 30 (still patient), the statement thru date must be 59 days from the statement from date.
-or-
The type of bill frequency is equal to 0 and condition code 21 is not present.Effective 10/01/00- This reason code is assigned for Home Health type of bills 329 and 339. The statement thru date must not be greater than 60 days after the from date 'OR-
If the patient status is equal to 30 (still patient), the statement thru date must be 59 days from the statement date.

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