Wiki Home care certification diagnosis incorrect

SMorris13

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Knoxville, TN
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Good morning.

We have received a denial on G0180 for a home health certification for missing/incomplete/invalid diagnosis. Generally when we bill these, we just copy the diagnoses directly from the plan of care document sent to us by the HHC provider. However, on this particular form, the top two diagnoses are K92.2, gastrointestinal hemorrhage, unspecified, and K29.00, acute gastritis without bleeding. These two diagnoses have an excludes 1 note (for obvious reasons) and I'm not sure if we are allowed to do anything to correct this. Can we request a corrected plan of care from the HHC company, or are we just out of luck? This plan of care is from about 6 weeks ago, we are just now receiving the denial.
Has anybody had any experience with this that could advise?
Thank you in advance!
 
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