“Notice of Admission (NOA) overlaps with existing home health admission” is the top reason for claim denials, according to CGS. The Medicare Administrative Contractor recently updated its list of top claim submission errors for home health and hospice.
At No. 2: Dates of service billed are within a beneficiary’s Medicare Advantage plan enrollment period.
The rest of the top ten are:
3. Statement "From" Date is on or after 01/01/2022 and less than 24 months from claim "Admit" Date and a matching Home Health Notice of Admission (NOA) cannot be found.
4. The dates of service fall within the span of days between the NOA receipt date and the claim From date on TOB 32X with Statement From Date on or after 01/01/2022, the NOA receipt date is 30 or more days from the claim From date, the payment amount returned from HH Pricer is equal to zero and the PROVIDER REIM field on MAP103A is blank.
5. This home health claim was submitted as a Medicare primary claim and contains exact service dates corresponding to a previously submitted claim for the same provider with at least one matching revenue code.
6. This reason code is assigned when there is no corresponding OASIS assessment found in Medicare's systems related to the claim.
7. Episode "To" date not 30 days greater than "From" date
8. The Fiscal Intermediary Standard System (FISS) has found a previously submitted billing transaction for the same beneficiary and dates of service with the same provider number; therefore, the second billing transaction submitted by the provider is a duplicate.
9. This claim was rejected due to an untimely Notices of Election (NOEs) or for Home Health claims with all line charges rejected.
10. The From and Through dates on HH claim are outside the HH Admission period.