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Top Claim Submission Errors for Home Health Providers: Error 31147

Reason for error: A home health final claim was received, and the fifth position of the HIPPS code billed contains the letters S, T, U, V, W, or X, but supply revenue codes are not present on the claim.

Claim processing result: Return to Provider (RTP)

How to prevent/resolve:

  • If the HIPPS code on your claim has a 5th position of S, T, U, V, W, or X and you provided non-routine supplies to the beneficiary during the episode, report
    • Supply revenue codes 027X and/or 0623
    • Service units
    • Charges and
    • A date of service that falls within the "FROM" and "TO" date of the home health claim
      • CGS encourages you to use the first Medicare billable visit in the episode as the date of service submitted with revenue codes 027X or 0623.

        Screenshot
  • If non-routine supplies were NOT provided by your home health agency to the beneficiary during the episode, the 5th position of the HIPPS code must be changed to the appropriate numeric value of 1, 2, 3, 4, 5, or 6. For example, if the HIPPS code for the episode was 2BFKV, it will need to be changed to 2BFK4 if non-routine supplies were not provided to the beneficiary. Make sure that when changing the 5th position of the HIPPS code from a letter to a number or vice versa, you do not change the supply severity level assigned to the HIPPS code for the episode. See the table below for the supply severity levels and corresponding values to report whether non-routine supplies were provided during the episode.
    Supply Severity Level Value if Supplies Provided Value if Supplies Not Provided
    1 S 1
    2 T 2
    3 U 3
    4 V 4
    5 W 5
    6 X 6
  • Please note that the fifth position of the HIPPS code does not need to match between the final claim and the request for anticipated payment (RAP). Therefore, if the RAP is reported with the fifth position of the HIPPS code of 1, 2, 3, 4, 5, or 6 and non-routine supplies were provided, the RAP does not need to be canceled prior to submitting the final claim.
    • However, you must ensure that the HIPPS code on the final claim is submitted with the corresponding letter for the supply severity level, and that the supply revenue codes, units, charges, and dates of service are present prior to submitting the claim.

Additional Resources

Updated: 05.16.19

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