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Operations Manager

bdye

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Question concerning the December 2007 of the Coding Edge. in the article, "Profit Potential: Home Health Plan Certification", it mentions towards the end of the article, that Item 23 of the 1500 form needs to include the provider number of the home health agency from which the patient is receiving the Medicare covered services from. Is this something new? Several of our offices that bill these codes have said that they have never included these numbers and were questioning as to why we would put that information on Line 23 (Prior Authorization Number). Can someone help me with this?
 

Kris Cuddy

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In Michigan, prior to WPS Medicare Part B retiring the policy 01/01/2008, it was required, along with beginning and ending dates in the local use text area of the billing software (box 19 on a HCFA).

We still continue to add the information in, as it may be required again. We don't get denials for having the HHA provider number on the claim.

Kris
 

bdye

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Kris - Thank you for your response. We can start putting these numbers in our system for possible future use, we just weren't sure about the line number to put these on - #23 or #19.
Betty
 

Kris Cuddy

Guru
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Location
East Lansing, MI
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Betty,

You're welcome. Definitely put the HHA provider ID in box 23, the beginning and end dates of the certification/recertification go into box 19 as B=XX/XX/XXX E=XX/XX/XXXX.

Take care,

Kris
 
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