July - September 2021, Home Health Medical Review Top Denial Reason Codes
Published 11/29/2021
We encourage all providers to review this information when filing claims to prevent denials and to ensure their claims are processed timely. The following information affects providers billing the 32X bill type.
There were a total of 1,252 claims denied for 32X bill type.
|
Rank |
Denial Code |
Denial Description |
# Claims |
% Claims Denied |
|
1 |
Auto Denial — Requested Records Not Submitted |
574 |
45.8 |
|
|
2 |
Face-to-Face Encounter Requirements Not Met |
373 |
29.8 |
|
|
3 |
No Plan of Care or Certification |
193 |
15.4 |
|
|
4 |
Visits/Supplies/DME Billed Not Documented/Not Documented As Used |
22 |
1.8 |
|
|
5 |
Unable to Determine Medical Necessity of HIPPS Code Billed as Appropriate Oasis Not Submitted |
9 |
0.7 |