If your NOA (RAP) was not submitted/accepted within the 5-day billing requirement, your agency can request an exception to the late-filing penalty, by appending the KX modifier to your final claim (EOE). You should also include sufficient remarks on why the NOA was submitted late.
If a home health agency (HHA) fails to submit a timely-filed NOA, it may request an exception, which, if approved, waives the consequences of late filing. The HHA should not file an appeal, as the exception process is a required action. To achieve this, the provider will need to include the KX modifier, along with the reason the NOA was late on the final claim (EOE). The KX modifier should not be submitted on the NOA. Please view the full PalmettoGBA article on "Late Notice of Admission: The Exception Process."
Here are the steps on how to get the KX modifier onto your End of Episode (EOE) claim:
a. Bill the NOA as usual
b. After the NOA has been created, go to Billing> PPS Billing > Edit PPS Episodes
c. Select the checkbox 2021 Late RAP Info (KX). A field will appear at the bottom to enter in your Remarks
d. Type in the reason the RAP (NOA) was late, then click Save Late RAP Reason
e. You will receive a popup " Late RAP Info Saved." Press OK
**When the EOE is created, it will show the KX modifier and the reason the NOA (RAP) was late.
If you put in remarks in error, or need to delete the KX/comments:
a. Remove the text from the comments field and press Save Late RAP Reason
b. You will get a popup "Do you want to remove the KX reason and the comments?" Press Yes to remove.
How Do I Get a Listing on all NOAs (RAPs) Submitted Late?
a. Go to Billing > PPS Billing > Reports > 14.03 PPS Tracking Report
b. Select "Episodes with KX - Late Reason"
c. Put in the applicate From and Through Dates for your search
d. Put in your specific Program/Payer/Team Code (s), or leave blank to search all
e. Click Print