What will happen if the supply severity level changes between the RAP and claim for the same episode of care?
Final claims where the non-routine supply severity level changes between the RAP and final claim for the same episode of care are returned to the provider for correction. For example, if the RAP is billed with HIPPS code 1AFKU, the HHA would bill 1AFK3 on the final claim if supplies were not provided to the beneficiary during the episode. Changes to the supply severity level between the RAP and final claim for an episode will cause the claim to be returned to the HHA for correction. To view a chart containing corresponding values for the supply severity levels, please see the Claims Processing and Reimbursement Changes for Home Health Supplies Web page. Medicare Learning Network (MLN) article, MM6393 also contains additional information.
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