(Medicare Claims Processing Manual Crosswalk)

Medicare Claims Processing Manual Home Health Agency Billing Crosswalk New. Chap. New. Sect. Int.  Pub. 13. HH Pub. 11 Program Memos Other          Description10 10 A3-3638.20  HH-401-402,HH-429   General Guidelines for Payment of HHA Claims 10 10.1 A3-3639 HH-467   Home Health Prospective Payment System (HH PPS) 10 10.1.1 A3-3639.1 HH-467.1   Creation of HH PPS 10 10.1.2 A3-3639.3 HH-467.3,    Commonalities of the Cost Payment and HH PPS Environments 10 10.1.3 A3-3639.5,A3-3639.6  HH-467.5, HH-467.6,    Configuration of the HH PPS Environment 10 10.1.4 A3-3639.7 HH-467.7,    The HH PPS Episode - Unit of Payment 10 10.1.5 A3-3639.8 HH-467.8,    Number, Duration, and Claims Submission of HH PPS Episodes 10 10.1.5.1  A3-3638.16,A3-3638.5  HH-439, 440   More Than One Agency Furnished Home Health Services 10 10.1.5.2 A3-3639.9 HH-467.9,    Effect of Election of HMO and Eligibility Changes on HH PPS Episodes New. Chap. New. Sect. Int.  Pub. 13. HH Pub. 11 Program Memos Other Description 10 10.1.6 A3-3639.10 HH-467.10,    Split Percentage Payment of Episodes and Development of Episode Rates 10 10.1.7 A3-3639.11 HH-467.11,    Basis of Medicare Prospective Payment Systems and Case-Mix 10 10.1.8 A3-3639.12 HH-467.12,    Coding of HH PPS Episode Case-Mix Groups on HH PPS Claims: (H)HRGs and HIPPS Codes 10   10.1.9 A3-3639.13,A3-3639.14  HH-467.13, HH-467.14   Composition of HIPPS Codes for HH PPS 10 10.1.10 A3-3639.15 HH-467.15,    Provider Billing Process Under HH PPS 10 10.1.10.1 A3-3639.16 HH-467.16,    Grouper Links Assessment and Payment 10 10.1.10.2 A3-3639.17 HH-467.17,    Health Insurance Query for Home Health Agencies (HIQH) Inquiry System Shows Primary HHA 10 10.1.10.3 A3-3639.18 HH-467.18,    Submission of Request for Anticipated Payment (RAP) 10 10.1.10.4 A3-3639.19 HH-467.19,    Claim Submission and Processing 10 10.1.11 A3-3639.20 HH-467.20,    Payment, Claim Adjustments and Cancellations 10 10.1.12 A3-3639.21 HH-467.21,    Request for Anticipated Payment (RAP) 10 10.1.13  A3-3639.22  HH-201.8E,  HH46722  Transfer Situation - Payment Effects New. Chap. New. Sect. Int.  Pub. 13. HH Pub. 11 Program Memos Other Description HH-467.22,  10 10.1.14 A3-3639.23 HH-467.23,    Discharge and Readmission Situation Under HH PPS - Payment Effects 10 10.1.15 A3-3639.28 HH-467.28,    Adjustments of Episode Payment - Partial Episode Payment (PEP) 10 10.1.16 A3-3639.24 HH-467.24,    Payment When Death Occurs During an HH PPS Episode 10 10.1.17 A3-3639.25 HH-467.25,    Adjustments of Episode Payment - Low Utilization Payment Adjustments (LUPAs) 10 10.1.18 A3-3639.26 HH-467.26,    Adjustments of Episode Payment - Special Submission Case: "No-RAP" LUPAs 10 10.1.19 A3-3639.27 HH-467.27,    Adjustments of Episode Payment - Therapy Threshold 10 10.1.20 A3-3639.29 HH-467.29,    Adjustments of Episode Payment - Significant Change in Condition (SCIC) 10 10.1.21 A3-3639.30 HH-467.30,    Adjustments of Episode Payment - Outlier Payments 10 10.1.22 A3-3639.31 HH-467.31,    Adjustments of Episode Payment - Exclusivity and Multiplicity of Adjustments 10 10.1.23 A3-3639.33 HH-467.33,    Exhibit: General Guidance on Line Item Billing Under HH PPS New. Chap. New. Sect. Int.  Pub. 13. HH Pub. 11 Program Memos Other Description 10 10.1.24 A3-3639.34 HH-467.34,    Exhibit: Acronym List 10 10.1.25 A3-3639.35, HH-467.35,  PM-AB-00-112  HH PPS Consolidated Billing and Primary HHAs 10          20 PM-AB-01-111,PM AB-01-65, Dated 4/26/01  Completion of Home Health Prospective Payment System (HH PPS) Consolidated Billing Enforcement 10 20.1     Exception of Supplies from Consolidated Billing Edits on Institutional Claims 10 20.2 PM-AB-01-70,Dated 5/1/01  Only RAP Received and Services Fall Within 60 Days after RAP Start Date 10 30 A3-3640 HH-468,    Common Working File (CWF) Requirements for the Home Health Prospective Payment System (HH PPS) 10 30.1 A3-3640.1 HH-468.1,    Health Insurance Query for Home Health Agencies (HIQH) 10 30.2 A3-3640.2 HH468.2,    HIQH Inquiry and Response 10 30.3 A3-3640.3 HH-468.3,    Timeliness and Limitations of HIQH Responses 10 30.4 A3-3640.4 HH-468.4,    Inquiries to RHHIs Based on HIQH Responses 10 30.5 A3-3640.5 HH-468.5,    National Home Health Prospective Payment Episode History File New. Chap. New. Sect. Int.  Pub. 13. HH Pub. 11 Program Memos Other Description 10 30.6 A3-3640.6 HH-468.6,    Opening and Length of HH PPS Episodes 10 30.7 A3-3640.7 HH-468.7   Closing, Adjusting and Prioritizing HH PPS Episodes Based on RAPs and HHA Claim Activity 10 30.8 A3-3640.8 HH-468.8,    Other Editing and Changes for HH PPS Episodes 10 30.9 A3-3640.9 HH-468.9,    Priority Among Other Claim Types and HH PPS Consolidating Billing for Episodes 10 30.10 A3-3640.10 HH-468.10,    Medicare Secondary Payment (MSP) and the HH PPS Episodes File 10 30.11 A3-3640.11 HH-468.11,    Exhibit: Chart Summarizing the Effects of RAP/Claim Actions on the HH PPS Episode File 10  40 A3-3638.22,A3-3638.13  HH-475,    Completion of Form CMS-1450 for Home Health Agency Billing 10 40.1 A3-3638.23 HH-475.1,    Request for Anticipated Payment (RAP) 10 40.2 A3-3638.24 HH-475.2,    HH PPS Claims 10 40.3 A3-3638.25 HH-475.3,    HH PPS Claims When No RAP is Submitted - "No-RAP" LUPAs New. Chap. New. Sect. Int.  Pub. 13. HH Pub. 11 Program Memos Other Description 10                   40.4 A3-3638.10  HH-400,HH-463 Def. of nom. Chg. from 42 CFR 410.2  Collection of Deductible and Coinsurance from Patient 10 40.5 A3-3638.14    Billing for Nonvisit Charges 10 50 A3-3638.30, PM-A-01-05 Benefici ary-Driven Demand Billing Under HH PPS 10 70  HH-475.4   HH PPS Pricer Program 10 70.1 HH-475.4.A  General10 70.2  HH-475.4.B   Input/Output Record Layout 10 70.3  HH-475.4.C   Decision Logic Used by the Pricer on RAPs 10 70.4  HH-475.4.D   Decision Logic Used by the Pricer on Claims 10 70.5  HH-475.4.E   Annual Updates to the HH Pricer 10 80  HHA 475.5   Special Billing Situations Involving OASIS Assessments 10 90 A3-3638.9,A3-3638.19 HH-461,    Medical and Other Health Services Not Covered Under the Plan of Care (Bill Type 34X) 10 90.1 A3-3638.21    Osteoporosis Injections as HHA Benefit 10 90.2     Billing Instructions for Pneumococcal Pneumonia, Influenza Virus, and Hepatitis B Vaccines New. Chap. New. Sect. Int.  Pub. 13. HH Pub. 11 Program Memos Other Description 10 100 A3-3638.17    Temporary Suspension of Home Health Services 10 110  HH-432   Billing Procedures for an Agency Being Assigned Multiple Provider Numbers or a Change in Provider Number