January to March 2024 Home Health Medical Review Top Denial Reason Codes

Published 06/06/2024

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 32X bill types.

32X Bill Type Denials: Total Denials 2,664

Rank

Denial Code

Denial Description

# Claims

% Claims Denied

1

56900

Auto Denial — Requested Records Not Submitted

1,338

50.2

2

5FF2F

Face-to-Face Encounter Requirements Not Met

752

28.2

3

5F023

No Plan of Care or Certification

305

11.4

4

5F301

Information Provided Does Not Support the M/N for Therapy Services

57

2.1

5

5T072

No Physician's Orders for Services

32

1.2

6

5T070

Visits/Supplies/DME Billed Not Documented or Not Documented As Used

31

1.2

7

5A301

Information Provided Does Not Support the M/N for Therapy Services

29

1.1

8

5A041

Information Provided Does Not Support the M/N for This Service

27

1.0

8

5F070

 

Visits/Supplies/DME Billed Not Documented or Not Documented As Used

27

1.0

10

5F072

No Physician's Orders for Services

18

0.7

 


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