Quick Tip: Using Revenue Codes 96X, 97X, and 98X Appropriately to Avoid Reason Codes 32391 and 36602 This information applies to Critical Access Hospitals (CAH) Method II (Optional method) providers only. The CAHs who have selected the Method II payment by Medicare can bill the professional services to the Intermediary using revenue codes 96X, 97X or 98X. These services must be performed by the physician or the nonphysician practitioner (NPP). Do not use these revenue codes if the physician or NPP did not perform the service. For example, if a physician orders the service and a nurse actually performs the service, this service is not paid as a professional service. The provider should use another revenue code to report that service. Avoiding Reason Codes 32391 and 36602 It is not appropriate to use revenue codes 96X, 97X, or 98X with all CPT or HCPCS codes. These revenue codes should only be used for services performed by the physician or the NPP. CAH Method II providers should also make sure that all applicable staff members that work with Medicare claims are aware of this and that all internal systems are updated with this information. |
