New York RiverSpring EDI Codes

New attendant assigned to client

Service(s) cancelled or suspended until further notice

Unverified visit; this service cannot be billed

Visit rescheduled

Agency unable to provide replacement coverage (no show, no replacement)

Client received services outside of the home

Client requested to change/cancel scheduled visit; or the scheduled visit has been cancelled due to the client's services being suspended

COVID-19: Participant is in hospital or Nursing Facility

COVID-19: Participant refused, receiving service through informal supports

COVID-19: Participant refused, self-isolating, not receiving service

COVID-19: Worker switched to cover another case

COVID-19: Worker unable to staff because of child care issues

COVID-19: Worker unable to staff because they are sick

COVID-19: Other

If selecting COVID-19: Other, please provide additional details in the Note section

PT evaluation

PT evaluation, outer county

OT evaluation

PT evaluation low complexity

PT evaluation low complexity, outer county

PT evaluation moderate complexity

PT evaluation moderate complexity, outer county

PT evaluation high complexity

PT evaluation high complexity, outer county

OT evaluation low complexity

OT evaluation low complexity, outer county

OT evaluation moderate complexity

OT evaluation moderate complexity, outer county

Speech Therapy visit/ routine

Speech Therapy visit/ routine, outer county

OT visit/ routine

OT visit/ routine, outer county

PT visit/ routine

PT visit/ routine, outer county

Evaluation of speech fluency

Evaluation of speech production

Therapeutic exercises

Neuromuscular Reduction

Massage Therapy

Manual therapy techniques, 15min

Therapeutic Activities

OT evaluation high complexity

OT evaluation high complexity, outer county

Speech Therapy evaluation

Respiratory therapy evaluation

Respiratory therapy routine

SW

RN

LPN

Nutritional Counseling

RN

LPN, 15 min

Home Attendant, 15 min

Home Attendant, 15 min, shared

Home Attendant, 15 min, outer county

Home Attendant, 15 min, shared, outer county

HA live in, 15 min

HA live in, 15 min, shared

HA live in, 15 min, outer county

HA live in, 15 min, shared, outer county

House keeper

PCA, 15 min

PCA, 15 min, shared

PCA, 15 min, outer county

PCA, 15 min, shared, outer county

PCA live in, 15 min

PCA live in, 15 min, shared

PCA live in, 15 min, outer county

PCA live in, 15 min, shared, outer county

CDPAS, 15 min

CDPAS 15 min, shared

CDPAS 15 min, outer county

CDPAS 15 min, shared, outer county

CDPAS live in, 15 min

CDPAS live in, 15 min, shared

CDPAS live in, 15 min, outer county

CDPAS live in, 15 min, shared, outer county

UAS

**Billing through HHAeXchange is not required at this time**

• Agency Tax ID

• Caregiver Code

• Caregiver First Name

• Caregiver Last Name

• Caregiver SSN

• Clock-In Service Location Type

• Clock-Out Service Location Type

• Diagnosis Code

• Medicaid Number

• Payer ID

• Procedure Code

• Schedule End Time

• Schedule ID

• Schedule Start Time

• Visit End Time

• Visit Start Time

*The EVV fields are required if visit was confirmed via EVV or IVR. Visit Edit and Action Taken codes are required if visit was manually edited.

• Agency Tax ID

• Caregiver Code

• Caregiver First Name

• Caregiver Last Name

• Caregiver SSN

• Is Deletion (Value should be “Y”)

• Medicaid Number

• Payer ID

• Procedure Code

• Schedule End Time

• Schedule ID

• Schedule Start Time

• Agency Tax ID

• Caregiver Code

• Medicaid Number

• Missed Visit (Value should be "Y")

• Missed Visit Action Taken Code

• Missed Visit Reason Code

• Payer ID

• Procedure Code

• Schedule ID

**Billing through HHAeXchange is not required at this time**

Confirmed visit with the Member or the Member's family member/representative and documented

Supervisor approved change

Updated Member's phone number and documented

Changed verification collection method and documented

Timesheet received and signed by supervisor

Confirmed visit with outside entity and documented

Visit rescheduled

Updated Member's address and documented

New attendant assigned to Member

Unverified visit; this service cannot be billed

Service(s) cancelled or suspended until further notice

Timesheet Verified

Mutual Case/ or Cluster Case/ or Live-in Cas

Phone number did not link to the client.

Client won’t let attendant use phone.

Client does not have a phone in home.

Phone in use by client or individual in member’s home.

Client received services outside of the home.

Client's phone line not working (technical issue or natural disaster).

Client requested to change/cancel scheduled visit; or the scheduled visit has been cancelled due to the Client’s services being suspended.

Address did not link to the client (GPS).

Attendant failed to call in.

Attendant failed to call out.

Attendant failed to call in and out.

Attendant called in to or out of the EVV system early or late.

Attendant's identification number(s) does not match the scheduled shift or task discrepancy/task does not match plan of care.

Attendant entered invalid fixed location device code(s).

Attendant failed to report to client's home.

Fixed location device on order or pending placement in the home.

Fixed location device malfunctioned.

Attendant unable to use mobile device.

Attendant unable to connect to internet or EVV system down.

Data Entry Error

Agency unable to provide replacement coverage (no show, no replacement).

Timesheet Received