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Home Health
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Reason Code U537I The FROM and THROUGH dates on the HH claim fall outside of an HH Admission period for the same provider. can someone tell me how can i fix this issue? thank you!

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I HAVE THESAME ISSUE OF U537I FOR SEVERAL MONTHS NOW. PLEASE PUBLISH SOLUTION TO IT IF HAPPEN TO KNOW THE SOLUTION TO FIX U537I

Kari White RN
Implementation Consultant

Good Day John!  I found this article from NGS.  Could your issue be the NOA?

 

Home Health Bill Type 32A Returning With Reason Code U537I


CMS implemented HH TOB 32A for the NOA effective for period of care claims on or after 1/1/2022. The NOA is required for all HH period of care claim billing, including demand billing (0329 TOB with cc 20) and no-pay, or insurance denial, billing (0320 TOB with cc21). It is important to ensure the NOA is billed within five calendar days of the start of care and processed prior to submitting any claim billing. If a claim has returned with the U537I reason code because there is not a processed 32A NOA in the system, the NOA must be submitted. Once it has processed, the returned claim can be resubmitted for processing.

If you have billed your NOA and it is one that spanned 2021-2022, check the artificial admit date on it. All of your finals for that admission will also have to have an admit date to match. For some reason it was working fine but I just started having occasional issues with Axxess not putting on the artificial admit date they used for the NOA and not putting the real admit date. Not sure why their system is putting random dates on them.