Two issues that Medicare Administrative Contractors (MACs) have reported during the transition to ICD-10 appear to be resolved.
 
One of the problems involved National Provider Identifiers (NPIs). It caused home health agencies and hospices nationwide to have problems submitting claims.
 
The issue involved NPIs “falling off the crosswalk, which is causing home health billing requests for anticipated payment (RAPs) and claims and hospice Notices of Election (NOEs) and claims to go to the provider’s Return to Provider (RTP) file,” MAC CGS said.
 
MACs first reached out to agencies about the issue in early October. CMS alerted the National Association for Home Care & Hospice (NAHC) on Oct. 14 that the problem had been addressed and that NOEs and RAPs would be processing normally, according to NAHC. At the time, NAHC said it appeared that a small number of providers were affected and, while the issue was ongoing, had difficulty processing any claims.
 
On Oct. 20, MAC Palmetto GBA announced that the problem appeared to have reemerged. But on Oct. 27, CGS alerted agencies that the issue has been resolved. CGS said that because providers aren’t able to see NOEs, RAPs and claims in their RTP file, the MAC was working to move affected claims out of the RTP file and allow them to continue processing.
 
Meanwhile, an unrelated Medicare claims issue also has been resolved, CGS announced Oct. 27. MACs notified agencies in mid-October that claims spanning Oct. 1, 2015, were incorrectly receiving reason code 31276. The reason code narrative states that “Outpatient claim contains an ICD-10 indicator of 9 and an ICD-10 diagnosis is present,” according to Palmetto.
 
CGS said on Oct. 27 that claims that were in the RTP file incorrectly “have been moved to continue processing as well as claims suspended in status/location S MICD1 with reason code 31276.” According to CGS, claims receiving reason code 31276 as of Oct. 28, 2015, are valid and will need to be corrected from an agency’s RTP file.