Recoding Health Insurance Prospective Payment System (HIPPS) Codes Through a Review Process

Current Status
9/12/17: There is no change to this issue and it is still in research. No provider action is required at this time.

Situation:
Palmetto GBA has identified that claims that required a change in HIPPS code during a review may not price correctly. This issue is only related to medically reviewed HIPPS code changes and we have not identified any other issues when the HIPPS changes through normal claim processing.

Impact to Providers:
This issue causes over and under payments on the affected claims.

Status:
9/12/17:
There is no change to this issue and it is still in research. No provider action is required at this time.

2/14/2017 - This issue is being researched. Palmetto GBA will provide an update as soon as available. No provider action is required at this time.

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