Top Claim Submission Errors for Home Health Providers: Error 31790
Reason for error: Due to data reporting requirements in Change Request 8136, for episodes beginning on or after July 1, 2013, home health agencies must report the HCPCS code Q5001, Q5002, or Q5009 to indicate the location of where services were provided.
HCPCS Code | Definition |
---|---|
Q5001 | Care provided in patient's home/residence |
Q5002 | Care provided in assisted living facility |
Q5009 | Care provided in place not otherwise specified (NO) |
Claims Processing Result: Return to Provider (RTP)
How to prevent/resolve:
- Report the HCPCS code indicating the location of service along with the 1st billable visit in the HH PPS episode.
- Report the HCPCS code only once on a claim unless the location changes.
- Report the HCPCS code on an additional line item with the revenue code and date of service, one unit, and a nominal charge.
- If the location changes, report a new line item with the appropriate HCPCS code along with the 1st visit provided in the new location.
Updated: 02.11.16