Commonwealth of Massachusetts Executive Office of Health and Human Services Office of Medicaid 600 Washington Street Boston, MA 02111 www.mass.gov/masshealth MassHealth Chronic Disease and Rehabilitation Outpatient Hospital Bulletin 2 January 2006 TO: Chronic Disease and Rehabilitation Outpatient Hospitals Participating in MassHealth FROM: Beth Waldman, Medicaid Director RE: Admission Hour Required on All Chronic Disease and Rehabilitation Outpatient Hospital Claims Background Transmittal Letter OPD-40, dated December 1994, transmitted item-by-item instructions for filling out the UB 92 claim form. MassHealth instructed providers to enter a two-digit code corresponding to the start time of the member’s visit into the admission hour field (Item 18). At the time, Item 18 was not required for claims processing. MassHealth has determined that outpatient claims can be processed more efficiently when the admission hour is provided on the claim. This includes situations where multiple providers submit claims for the same MassHealth member on the same date of service. Therefore, effective for dates of service on and after March 31, 2006, the admission hour of the outpatient service (Item 18 on the UB92; Field DTP03 in loop 2300, Admission Date/Hour in the 837I) will be required for any outpatient service claim. Outpatient claims that are submitted without the admission hour information entered as required in the above-referenced billing instructions will be denied with Error Code 655 (invalid or missing time of admission). Information on Web This bulletin, as well as all other MassHealth bulletins and transmittal letters, is available on the MassHealth Web site at www.mass.gov/masshealth. Click on “MassHealth Regulations and Other Publications.” Questions If you have any questions about the information in this bulletin, please contact MassHealth Customer Service at 1-800-841-2900, e-mail your inquiry to providersupport@mahealth.net, or fax your inquiry to 617-988-8974.