Home Health & Hospice

CMS Issues Change Request Regarding Demand Bills

Homecare Insider, February 20, 2012

Homecare providers must continue to stay updated regarding policy and manual changes that are issued by the Centers for Medicare and Medicaid Services (CMS). CMS issues these changes in the form of transmittals entitled Change Requests (CRs), which are usually accompanied by a Medicare Learning Network (MLN) Matters article.

For example, on December 22, 2011, CMS issued CR 7660 followed by MLN Matters article number MM7660. The effective (and implementation) date of this change is March 22, 2012 and it provides additional instructions and clarifies two sections of Chapter 10 in the Medicare Claims Processing Manual. CMS recently discovered that Medicare’s instruction regarding the reporting of the “Total Charges” field on claims is in conflict with the requirements of the HIPAA Standard 837: Institutional Claim Format. Standard 837 requires that the “Total Charges” field (SV203) always be reported and that zero is an acceptable value.Medicare’s instructions since 2000 have stated that the field may be zero or blank. A revised Chapter 10, Section 50 also provides additional billing instructions to assist providers in preparing demand bills when requests by the state Medicaid program do not correspond to dates of existing episodes of care.

Home Health specific transmittals can found here as can the accompanying MLN Matters article, both of which are listed in the “Downloads” section of the transmittal.