CMS’ Medicare Administrative Contractors (MACs) have alerted providers to a new system issue with the Notice of Admission (NOA). The NOA replaced the RAP in 2022 as the way for an agency to note it is the primary home health provider for a patient at the start of care.
According to the MACs, an issue is incorrectly assigning reason code U537F on some NOAs due to the common working file not correctly recognizing discharges.
A system fix to correct the issue is being created, but an implementation date has not been established. There is no workaround at this time, according to Palmetto GBA’s alert on Jan. 31, 2022.
“Providers need to ensure RC U537F edited correctly on their NOA, if applicable,” Palmetto noted in its claims issue log.
All of the MACs have encouraged agencies to make sure a return to provider for U537F was for an appropriate reason. The code is used correctly when:
- There is an open home period on file (Patient Status 30) from a different home health agency, regardless of the period date. Condition Code 47 should be applied to the NOA in this scenario, Palmetto notes.
- Duplicate NOAs were submitted. In this scenario, one of the two NOAs is usually returned with U537F. The other NOA will process if there are not additional reasons why it cannot. Providers do not need to take action with the duplicate NOA that returned for RC U537F, but shall follow the other NOA to ensure it processes/approves.
See more coverage on other recent NOA issues at HHL:
The MAC alerts: