CMS Corrects Edit of HIPPS Codes for Home Health Claims

With an implementation date of 10/05/09, CMS created a payment safeguard that ensures home health agencies no longer incorrectly change the supply severity level reflected in the 5th position of Home Health Prospective Payment System (HH PPS) Health Insurance Prospective Payment System (HIPPS) codes.  The fifth position of the HIPPS on the final claim can only differ from the fifth position of that code on the Request for Anticipated Payment (RAP) in cases where supplies were initially expected to be required, but were not supplied.  Then, the code can only change from the S-X letter code on the RAP to its correspondence number (1-6) code on the final claim.

HHAs should change the fifth position of the HIPPS code on HH PPS claims only in order to report cases where supplies were or were not provided during the episode.

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