Other Editing Related to Home Health Consolidated Billing

20.2.3 - Other Editing Related to Home Health Consolidated Billing (Rev. 10758; Issued: 05-11-21; Effective: 01-01-22; Implementation: 08-11-21) CWF edits to prevent duplicate billing across two providers. Consequently, CWF must edit to ensure that all DME items billed by HHAs have a line-item date of service and HCPCS code, even though HH consolidated billing does not apply to DME by law. If revenue code 0636 and the HCPCS code for an osteoporosis drug is billed on a TOB 034x claim during an open HH period of care, CWF ensures that the provider of the 034x claim is the same as the primary provider of the open period of care, since by law consolidated billing must also be applied to the osteoporosis drug even though this item is paid outside of the unit of payment. HH consolidated billing will not affect billing of DME or services outside the home health benefit, even when these services are billed by HHAs.