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PAP233

Home Healthcare Coding


Provider Administrative Policy

Section
Claims Submission
Policy Date
February 2008
Status/Date
Revised/October 2013
Provider Type(s)
All Providers  

Disclaimer

Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts


Policy

Home Healthcare Coding

Facility-based home healthcare providers contracted under the hospital and freestanding non facility-based providers should submit claims on a UB-04 form.  Non facility-based providers must submit all charges with a corresponding CPT or HCPCS code to be considered for payment.

Coding
Blue Cross of Idaho currently accepts four-digit revenue codes.

Contracting Hospital Providers
Use revenue codes 0421, 0431, 0441, 0550, 0551, 0570, 0580, 0581 or 0590. Use the appropriate CPT-4 or HCPCS codes for the current year. Blue Cross of Idaho does not allow Medicare temporary HCPCS codes, with the following exceptions: G0151, G0152, G0153, G0154 and G0155. We allow these HCPCS codes because there are no alternate codes in the CPT range that describe a visit by a skilled nurse or home visits by a physical, occupational or speech therapist.  Per diem HCPCS codes are not reimbursable under freestanding, non-facility based contracts.

Nursing Visits
Blue Cross of Idaho does not cover nursing travel time. A home IV company may subcontract nursing visits to an independent nursing agency or hospital-based home nursing provider. In these cases, the home IV company agrees to directly reimburse the home healthcare agency for such services. Blue Cross of Idaho will not reimburse individual home health care claims during a home IV per diem authorization. Charges for the administration of IV medications or nursing care associated with Home IV services, travel time, custodial care, per diem nursing rates and all other services that are not addressed on the Fee Schedule will have a zero ($0) payment allowance.


Policy History

Date Action Reason
October 2013 Revised Added contract language to "Nursing Visits"
September 2011 Revised G0155 added under CPT/HCPC exceptions
April 2010 Revised CPT/HCPCS statement added
January 2010 Revised Change billing to UB-04
July 2009 Revised Per diem language added
November 2008 Revised FEP information added

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