Jul 21, 2016
A modification is being included in the October update (v5216) that may require action from your Software Vendor. An issue was discovered where codes submitted with lowercase characters were flagged as invalid in the grouper. ICD-10 codes are not case sensitive; however, the Home Health grouper currently expects all uppercase codes. Submitted codes were required to exactly match the code in the grouper tables. For the October v5216 release the logic will allow mixed case codes.
The majority of providers submit uppercase codes, or if lowercase codes are submitted, they are converted to uppercase in the vendor software. If this is not the case, providers must resubmit any claims which were submitted which contained lowercase codes. The CMG (case mix group) score and HIPPS code may have been generated incorrectly, despite the claim being accepted as valid.