Palmetto and CGS have posted that this issue is now resolved and NOA records are no longer being Returned to Provider (RTP) with Reason Code 32114. If an NOA was late due to this issue, enter the remarks required by your agency's MAC in the Remarks field of the final claim (ex. Jan 2022 Issue RC 32114). See the NOA Creation FAQ for instructions on submitting a Late NOA Exception Request.

RTP 19960

Some agencies have had NOAs RTP for Reason Code 19960 - Condition Code Other Than 47 when the MAC system had added a Condition Code 15 to the record. Palmetto has posted that this issue is now resolved.  If an NOA was late due to this issue, enter the remarks required by your agency's MAC in the Remarks field of the final claim (ex. Late due to CC 15 release). See the NOA Creation FAQ for instructions on submitting a Late NOA Exception Request.

If a Home Health Notice of Admission (NOA) has been entered via DDE instead of via Electronic Claims Submission, users must:

• Enter the date the NOA was submitted in the Patient>Admit>Add'l-Data>NOA-Date field.
• For patients admitted prior to 2022, the Artificial Admit Date (the start date of the first 2022 billing period for that patient) must be entered in the Benefit-Start Date field (check the Is-Hospice flag to enable this field and un-check after saving the changed date). Failure to complete this step will cause Final Claims to generate without the required Artificial Admit Date.

In version 1.2.8.84 a new Sequester charge replaces the Initial PPS Claim Charge in the Insurance Rates tab for Medicare payers.

The Sequester charge also eliminates the need for separate Level of Care rates to handle sequestration for Medicare Hospice payers. It is recommended that agencies switch to this new method, although the older method is still supported for hospice claims.

As of December 2021, the 2% sequestration payment adjustment for all Medicare Fee-For-Service (FFS) claims has been suspended until 3/31/2022, at which point a 1% adjustment would be active through 6/30/2022. The full 2% amount would then be applied starting 7/1/2022.  Since these amounts and dates are still subject to change due to possible future legislation, at this time we recommend that only the 2% sequestration ending 4/30/2020 should be present. Review the Sequestration Rates FAQ for details on the new Sequester charge and steps to update the Medicare Insurance Rates. This document will be updated with steps on entering any future sequestration rates at a time closer to their implementation dates.

Value Based Purchasing

Back to Client Advisories List...