A new Override to remove the new FIPS, Value Code 85 from PPS Claims for Commercial Insurances not requiring the value code has been added with Main Office Software version 6422 Dated 01/17/19. The Override can be found in Insurance/PPS tab labeled ‘Exclude FIPS Value Code 85′. The override will remove the new value code for Insurance companies requiring PPS style billing but not requiring the new value code.

Agencies who have received claim rejections for Value code 85 on PPS claims with date of service prior to January 1,2019 will need main Office software version 6420 dated 01/16/19 or later. Prior software versions placed the new Value Code in 2018 PPS Claims causing rejections. Software version 6420 will correct this issue.

Main Office Software version 6420 dated 01/16/19 and Clinical Point of Care software version 2760 dated 01/16/19 will contain enhancements to Advanced Directives. Additional Fields have been added to the data entry fields in the Comprehensive OASIS Assessments for POA, DPOAHC, and Living Will. If documentation is present indicating a patient Emergency Contact is a POA or DPOAHC the data will automatically be indicated in the Advanced Directive documentation section.
Advanced Directive will now have a distinct section in the Plan of Care/485 data entry fields in the Risk/Support tab.
A separate distinct Advanced Directive section print below the Patient Diagnosis on the Plan of Care Print Form.

Main Office Software version 6419 dated 01/15/2019 will correct a Validation Report warning some agencies are receiving for submitted HIPPS code does not match the calculated HIPPS code upon xml file submission. A correction has been made to the point calculation in the Clinical domain. Typographical errors in the PPS Summary sheet have been completed in the Functional domain.

Enhanced Error checking has been made available for OASIS Assessments with Main Office Software version 6415 dated 01/11/19 and Clinical Point Of Care Software version 2759 dated 01/11/19.
The enhanced error checks are related to the new GG and JJ question responses that will cause a Fatal Rejection when submitted to CMS but are not associated with a designated skip pattern.

Agencies should update to Main Office software version 6411 dated 01/09/19 prior to submitting OASIS XML files for Recertification and Other Follow up OASIS Assessments.
The latest version will correct an issue related to M1860 in the xml file. No change in data entry is required.

Agencies should have Main Office software version 6409 dated 01/08/19 and Clinical Point of Care software version 2756 dated 01/08/19 to receive the latest most complete OASIS D error checking.

Agencies should have Main Office Software version 6409 dated 01/08/2019 or later prior to submitting OASIS D XML files.

Main Office software version 6408 dated 01/07/2019 will include the new requirement for Value Code 85 with corresponding FIPS code for Rural CBSA codes in Medicare PPS electronic ANSI 837I Claim files. The Value code and FIPS code will populate automatically based upon the current county set in the software.
Please note: The new Value code will not be included on the print form of the paper UBO4 generated for agency records at this time but is present in the ANSI claim file.

Agencies will need Main Office software version 6404 dated 01/03/19 or later to successfully submit OASIS C2 xml files.

Agencies will need to have Main office software version 6401 dated 01/02/2019 and Clinical software version 2741 dated 12/31/19 for the latest updates related to OASIS D data entry fields. Additional updates will be released in the coming day(s) to update OASIS D error checks. An additional message will be posted on Allegheny Messages at the time of the version update to resolve all OASIS Error/edit checks.

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