31018

FISS Narrative
This reason code is assigned for home health type of bills 329 and 339.

Either:

  • There is more than a span of 60 days between the 'FROM' and 'TO' date submitted
  • There are fewer than 60 days between the 'FROM' and 'TO' date submitted and the patient’s status code reflects '30' on the claim

Explanation and Suggestion

Either:

  • The unit of payment under the Home Health Payment System (HH PPS) is for a 60 day episode of care. Claims submitted should not reflect more than 60 calendar days on a final claim (TOB 329 or 339).
  • Verify the patient status code. Patient status code '30' indicates that the patient is still a patient of the HHA at the end of the episode. As a result, the 'FROM' and 'TO' dates submitted may not be less than 60 days.

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Provider Contact Center: 855-696-0705

TDD: 866-830-3188

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