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Home Health Claims - New Grouper Return Code Edits and Informational Unsolicited Respons

The purpose of this Change Request (CR) is to add new claims edits in response information returned from the Home Health (HH) Grouper, so HH claims receive clearer error messages. It also creates a new informational unsolicited response (IUR) to Medicare systems to correct partial episode payments.

Download the Guidance Document

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: October 06, 2022

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.