Claims Payment Issues Log


Here is a list of system-related claims payment and processing issues. These issues have been reported to the Centers for Medicare & Medicaid Services (CMS) and/or the Fiscal Intermediary Standard System (FISS). Please check often for updates before contacting the provider contact center. The issues are identified by stand alone articles and will be updated as needed.


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RESOLVED: Home Health: PCR Duplicate Request RejectionsOPEN: Home Health Core-Based Statistical Area (CBSA) Code 50007 Payment IssueOPEN: Home Health Claims with Post-Acute Stay in an Inpatient Rehabilitation Unit or a Psychiatric Unit of a Critical Access Hospital Within 14 Days of the Home Health AdmissionRESOLVED: Home Health Claims Editing for Reason Code 31755RESOLVED: Home Health: Medicare System Not Recoding the Health Insurance Prospective Payment System (HIPPS) Code on Some ClaimsRESOLVED: Hospice High/Low Payment Rates for Routine Home Care (RHC)RESOLVED: Home Health: Payment on Claims When the Requests for Anticipated Payment Were Submitted More than 30 Days LateRESOLVED: Home Health Possible Overpayments on Partial Episode Payments (PEPs)RESOLVED: Home Health 2022 Payment Adjustment for the Home Health Value-Based Purchasing ModelRESOLVED: Suspension of Home Health Claims with Reason Code 39910 When the Requests for Anticipated Payment (RAP) Were Submitted More than 30 Days LateRESOLVED: April 7, 2022, Remittance Advice Details for SC Part A, Home Health and Hospice ProvidersOPEN: Home Health Notice of Admission (NOA) Reason Code U537F, Home Health Admission OverlapOPEN: Home Health: 32G Adjustments Are Recoding the Health Insurance Prospective Payment System (HIPPS) Codes from Late to Earlier Periods on Home Health Claims When There Is Separation Between the Periods of Less than 60 DaysOPEN: Some Home Health RCD Postpayment Adjustments, 32I Type of Bill, Are Incorrectly Changing Patient Status to 01: Discharge to Home

Last Updated: 01/01/2020