tci Medicare Compliance & Reimbursement - 2015 Issue 21

Industry Note: ICD-10 Glitch Takes Down Home Health Claims

Sit tight for adjustments, Medicare Administrative Contractors instruct. Home care providers hoping for a smooth transition to ICD-10 have seen their cash flow disrupted by Medicare claims system glitches. Latest problem: “Claims with dates of service that span into October 2015, with correct ICD-10 diagnosis codes, are receiving reason code 31276; however, the Fiscal Intermediary Standard System (FISS) edits as if the claim is prior to October 1, 2015, and includes ICD-10 codes,” described Home Health & Hospice Medicare Administrative Contractor CGS in a message to providers. For the rejections, “the reason code narrative states &lsquo...

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