Home Health Notice of Admission Processing Issues Continue (From NAHC)

NAHC Report readers are probably aware that  implementation of the notice of admission (NOA) at the beginning of this year has gotten off to a rocky start. (See January 20, 2022 NAHC Report.) Home health agencies began experiencing problems with the NOA submissions right away due to an issue at the Centers for Medicare & Medicaid Services (CMS) and some MAC-specific systems issues, but most of the issues were fixed at the end of January.

However, there is one issue that was identified after the fix was implemented and this is the reason code U537F is assigning incorrectly on some NOAs when the Common Working File (CWF) does not correctly recognize a discharge (patient status other than 30 on the last HH period). There is no workaround.  A system fix to correct this issue is being created, but an implementation date has not been established.

NOAs are supposed to return to provider (RTP) with reason code U537F if the “From” date of the NOA falls within an existing home health admission period unless condition code 47 is present or the CCN (CMS Certification Number/provider number) on the NOA matches the CCN on the admission period.  In situations where duplicate NOAs were submitted, one or both of the NOAs may RTP with U537F. If only one of the NOAs is returned with U537F, the other should process if there are not additional reasons why it cannot.

Providers do not need to take action with the duplicate NOA that returned for U537F but shall follow the other NOA to ensure it processes/approves.

Providers are reminded to ensure a pending/not finalized (suspended) NOA does not exist before submitting a new NOA for a beneficiary admission and to utilize condition code 47 on the NOA when the beneficiary has been discharged from another HHA, but the period of care claim has not been submitted or processed at the time of the new admission to discharge the beneficiary.