An issue is causing home health final claims spanning Oct. 1, 2015, to incorrectly be rejected/returned to provider (RTP’d), according to Medicare Administrative Contractors (MACs) Palmetto GBA and CGS.
 
The scope of the issue isn’t immediately clear.
 
Claims are being RTP’d with reason code 31276. The reason code narrative states "Outpatient claim contains an ICD-10 indicator of 9 and an ICD-10 diagnosis is present,” according to Palmetto.
 
MACs "are suspending these claims, including those already rejected/returned to providers," a spokesman for Palmetto and CGS tells HHL." MACs are currently manually processing these suspended claims upon receipt, bypassing the edit causing the problem, until a system fix is implemented. No provider action is required; however, contact your MAC if you have questions."