April 1, 2010, Home Health & Hospice Medicare A Newsline - CGS

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Please review the following instructions to access the Home Health Pymt Totals screen (Map 1B41) andhow to obtain your facility’s payment information.1. From the FISS Main Menu (Map 1701), type 01 in the Enter Menu Selection field and press Enter.2. From the Inquiry Menu, type 67 in the Enter Menu Selection field and press Enter.MAP1702 CAHABA GBA - RHHI ACPFAT01 XX/XX/XXXXXXXX INQUIRY MENU C201014S XX:XX:XXBENEFICIARY/CWF 10 ZIP CODE FILE 19DRG (PRICER/GROUPER) 11 CLAIM COUNT SUMMARY 56CLAIMS 12 HOME HEALTH PYMT TOTALS 67REVENUE CODES 13 ANSI REASON CODES 68HCPC CODES 14 CHECK HISTORY FIDX/PROC CODES 15ADJUSTMENT REASON CODES 16REASON CODES 17ENTER MENU SELECTION: 67PLEASE ENTER DATA - OR PRESS PF3 TO EXIT3. The Home Health Payment Totals Inquiry screen (Map 1B41) appears:MAP1B41 CAHABA GBA - RHHI ACPFAT01 XX/XX/XXXXXXXX SC HOME HEALTH PAYMENT TOTALS INQUIRY C201014S XX:XX:XXPROVIDERNPISEL YEAR OUTLIER TOTAL PAYMENT TOTALPLEASE ENTER DATA - OR PRESS PF3 TO EXIT4. Type your facility’s Provider Transaction Access Number (PTAN) (also known as your OSCAR/Legacyprovider number) in the PROVIDER field.5. Tab to the NPI field and type your facility’s National Provider Identifier (NPI), and press Enter.The Home Health Payment Totals Inquiry (Map 1B42) screen displays the total home health paymentand outlier totals for up to three years beginning with calendar year 2010 HH PPS payments.Home Health & Hospice April 1, 2010 41Medicare A Newsline Vol. 17, No. 7
MAP1B41 CAHABA GBA - RHHI ACPFAT01 XX/XX/XXXXXXXX SC HOME HEALTH PAYMENT TOTALS INQUIRY C201018E XX:XX:XXPROVIDER XXXXXX NPI XXXXXXXXXXSELYEAR OUTLIER TOTAL PAYME NT TOTAL2010 0.00 2,999.990000 0.00 0.000000 0.00 0.00PROCESS COMPLETED --- PLEASE CONTINUEPLEASE MAKE A SELECTION, ENTER NEW KEY DATA, OR PRESS PF3 TO EXITThe payment information is updated only after HH PPS claims are in FISS status/location (S/LOC) P B9997(paid). In addition, only HH PPS claims with “TO” dates on or after January 1, 2010, are included in thedata currently available.6. To display a list of claims that comprise the outlier and payment totals for a specific year, type an S inthe SEL field next to that year. Press Enter.MAP1B41 CAHABA GBA - RHHI ACPFAT01 XX/XX/XXXXXXXX SC HOME HEALTH PAYMENT TOTALS INQUIRY C201018E XX:XX:XXPROVIDER XXXXXX NPI XXXXXXXXXXSEL YEAR OUTLIER TOTAL PAYMENT TOTALS 2010 0.00 2,999.990000 0.00 0.007. The Home Health Payment Totals Detail (MAP 1B42) screen appears with individual claim data andthe corresponding value code amounts that reflect outlier and total payment amounts.MAP1B42 CAHABA GBA - RHHI ACPFAT01 XX/XX/XXXXXXXX SC HOME HEALTH PAYMENT TOTALS DETAIL C201018E XX:XX:XXPROVIDER XXXXXX NPI XXXXXXXXXX YEAR 2010DATE HIC NUMBER DCN VALUE CD 17 VALUE CD 64 VALUE CD 650102 123456789A 12312312312312IDR 0.00 0.00 1,999.990103 987654321A 98798798798798IDR 0.00 0.00 1,000.00PROCESS COMPLETED ---PRESS PF3-EXIT ENTER-CONTINUENO MORE DATA THIS TYPEIn the above example, no outlier payments were made to the two individual claims shown. The amountdisplayed below the “Value CD 65” field indicates that the HH PPS payment for the two claims were fromthe Medicare Part B trust fund.Home Health & Hospice April 1, 2010 42Medicare A Newsline Vol. 17, No. 7
Page 1 and 2: Home Health & HospiceMedicare A New
Page 3 and 4: H1N1 Influenza ImmunizationsMedicar
Page 5 and 6: Revised Medicare Physician Fee Sche
Page 7 and 8: classified (NOC) drug pricing files
Page 9 and 10: DisclaimerThis article was prepared
Page 11 and 12: BCTransfer From AnotherHome Health
Page 13 and 14: BackgroundWhen the National Uniform
Page 15 and 16: Key OPPS Updates for April 20101. P
Page 17 and 18: carrier or A/B MAC cannot provide a
Page 19 and 20: Note: Medicare contractors may adju
Page 21 and 22: Additional InformationFor complete
Page 23 and 24: Implementation of Home Health Agenc
Page 25 and 26: Provider Types AffectedThis article
Page 27 and 28: A. CMS has alerted MAC audit staff
Page 29 and 30: interpretation is billed and no E/M
Page 31 and 32: The provider may not bill the patie
Page 33 and 34: Claims in the “S MXXXX” status/
Page 35 and 36: In addition, the provider will also
Page 37 and 38: For more detailed information about
Page 39 and 40: Can Cahaba provide guidance to us r
Page 41: Medicare Credit Balance Quarterly R
Page 45 and 46: Resolving Reason Code U538FThe Caha
Page 47 and 48: A2. Yes, you are correct. The langu
Page 49 and 50: medical director of the hospice or
Page 51 and 52: Cahaba GBA Learning Corner‣ “Cl

April 1, 2010, Home Health & Hospice Medicare A Newsline - CGS

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