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Home Health Medical Review Top Denial Reason Codes: January through March 2021

Published 08/09/2021

January — March 2021, Home Health Medical Review Top Denial Reason Codes
We encourage all providers to review this information when filing claims to prevent denials and to ensure their claims are processed timely. The following information affects providers billing the 32X bill type.

There were a total of 3,072 claims denied for 32X bill type.

Rank	Denial Code	Denial Description	# Claims	% Claims Denied
1	56900	Auto Denial — Requested Records Not Submitted	1,518	49.4
2	5FF2F	Face-to-Face Encounter Requirements Not Met	944	30.7
3	5F023	No Plan of Care or Certification	210	6.8
4	5FNOA	Unable to Determine Medical Necessity of HIPPS Code Billed as Appropriate Oasis Not Submitted	170	5.5
5	5T070	Visits/Supplies/DME Billed Not Documented/Not Documented As Used	47	1.5

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