Home Health Claims Returning to Provider RC 19963
Date Reported:
04/25/2024
Date Updated:
03/24/2025
Date Resolved:
01/06/2025
Status:
Closed
Provider Types Impacted:
HH providers billing HH claims with NOA processed dates in January 2022.
Reason Code(s):
19963
Claim Coding Impact:
N/A
Description of Issue
HH claims are returning to provider in error with RC 19963. This impacts HH claims with NOA/processed dates in January 2022. NOAs are being purged after 24 months. Please keep in mind there are claims that edit correctly for this reason code. RC 19963 assigns correctly if:
- There is no NOA on file for that admission,
- The NOA was submitted but was rejected/RTP
- The NOA was cancelled by the home health agency (HHA) and never resubmitted,
- The NOA and claim admission dates do not match, or
- The admission was closed by another claim with an earlier service date.
National Government Services Action
The fix was implemented on 1/6/2025.
Provider Action
No provider action is needed.
Proposed Resolution/Fix
The fix was implemented on 1/6/2025.