NGS Provides Update on Home Health LUPA Claims Rejecting in Error

Situation Report | April 26, 2021

National Government Services (NGS), New York’s principal Medicare Administrative Contractor (MAC), has recently provided an update regarding home health low utilization payment adjustment (LUPA) claims rejecting in error.

Reason Codes 39929 (claim level) and 37363 (line level) are indicating incorrectly that request for anticipated payment (RAP) claims have been submitted beyond timeliness limits. 

NGS is working with the U.S. Centers for Medicare and Medicaid Services (CMS) to resolve this error. NGS states that a workaround has been applied and claims will no longer deny at the claim or line level before final processing and that claims that previously denied in error will be reprocessed within 30 days. 

No home health provider action is needed; however, NGS states that providers should continue to monitor the Production Alerts section of NGS’s website and future NGS e-mail updates.