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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