GLMI has recently discovered that Home Health Medicare MAC’s are incorrectly placing claims into T-Status. Please review the following notice from NAHC Regulatory Affairs :
Claim Processing Issue: Reason Code 32403 on Home Health Claims
The Fiscal Intermediary Standard System (FISS) maintainer has been notified of an issue affecting home health claims with dates of service prior to January 1, 2017. Reason code 32403 is being received incorrectly on claims when HCPCS code G0163 and G0164 are reported with a line item date of service prior to January 1 2017. At this time, these claims appear in status/location S MFEES, or in the Return to Provider file at T B9997.
With Change Request 9736, which was implemented with the January 2017 system release, codes G0163 and G0164 were retired and are no longer valid for services on or after January 1, 2017; however, they are valid for line item service dates prior to January 1, 2017. For additional information, please refer to the MM9736External PDF Medicare Learning Network Matters® article.
Please also refer to GLMI’s earlier note regarding the new G-codes for 2017, here. The system will pull the new G-codes into claims with dates of service on or after January 1, 2017, however agencies will need to add the G-codes into the modifier section of the service codes within your agency’s support files.
If your agency’s Medicare claims are placed into t-status for this reason, please contact your MAC.