Important Update for Home Health: Medicare System Not Recording HIPPS Code on Some Claims

An important update from Palmetto GBA:

“On some claims, the submitted HIPPS code is not being replaced by the system-calculated code, when applicable. As stated in the Section 4.02 of the Home Health Billing Manual, agencies HH PPS claims must report a 0023 revenue code line on which the first four positions of the HIPPS code match the code submitted on the RAP. This HIPPS code is used to match the claim to the corresponding RAP. After this match is completed, grouping to determine the HIPPS code used for final payment of the period of care will occur in Medicare systems. At that time, the submitted HIPPS code on the claim will be replaced with the system-calculated code. This issue has been reported and is in research. Providers should not cancel claims or RAPs to address this issue.”

Please make sure your staff are aware of this issue!

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