Knowledge Base Article #1458:

CarePortal Billing Integrity Error: Therapy visit count (“n”) exceeds threshold. Episode includes no assessments for which M0825=Yes or M0826 contains a number.

Question: How do I resolve the billing integrity grid Error "Therapy visit count (“n”) exceeds threshold. Episode includes no assessments for which M0825=Yes or M0826 contains a number."?

Answer: The RAP was sent using an HHRG / HIPPS code where M0825 response equals “No”. The integrity grid reports that the therapy visit of the associated final claim exceeds the therapy threshold. You will need to cancel the RAP in FISS; then un-bill the RAP in WORKFLOW – Operations – Un-bill Claims; inactivate the assessment; edit the M0825 response and re-submit the RAP with the revised HHRG / HIPPS code.

 

Keywords: CarePortal, Integrity, Billing, Financial, Grid, Error
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