Provider NewsFlash

July 2013

Service Authorization Forms: Incorrect HCPC/Modifiers Codes Corrected

Purpose of this communication

  • To inform providers that they may have received a Service Authorization Form (SAF) showing incorrectHCPC/modifier code combinations, which do not match their contract or the billing crosswalk. CareCentrix has corrected and reissued SAFs to all impacted providers.

What do I need to know?

  • From June 22, 2013 through July 2, 2013, there was a system error that incorrectly authorized a “G” HCPC code or other incorrect HCPC/modifier code combinationsto Traditional Home Health providers. The impacted codes can be identified because they do not match the correct HCPC/modifier codecombinations as listed on the billing crosswalk or in your provider contract.
  • Over the past two weeks, correctedSAFshavebeen systematically reissued via fax and posted to our portal forall impacted providers. Thereissued HCPC/modifier code combinationscan be verified as correctusing the billing crosswalk located on our provider portal, If you notice any code is still incorrect, please contact the Regional Care Centerimmediately to have it corrected.

What do I need to do?

  • If your home health agency received an authorization for a HCPC/modifier code combination that does not match your CareCentrix contract or the billing crosswalk, please do not wait to bill for services rendered. Timely filing is 45 days from the date of service (or, as determined by state law). Providers should bill, as normal, using the HCPC/modifier combinations listed in your contract and on the billing crosswalk,even if the incorrect code was originally indicated on the SAF.
  • Since CareCentrix has systematically reissued the correct HCPC/modifier code combinations, we do not expect providers to receive claim denials for this reason; however, if you confirm that you have billed the correct HCPC/modifier combination as listed in your contract andyou receive a claim denial due to an incorrect HCPC/modifier combination originally shown on your SAF, please contact the Provider Resolution Team at (877) 725-6525, Option 1, Option 2 immediately for assistance with adjusting your claims.
  • Providers may refer to their contract or the billing crosswalk at for the correct HCPC/modifier combinations to bill.

We apologize for any inconvenience that this may cause.

Thank you for your cooperation.