Posted on Monday, October 2, 2017 12:25 PM
Accepting Hospice Notice of Election via EDI
On July 27, 2017 CMS released Change Request 10064. This Change Request allows for the submission of the Hospice Notice of Election via Electronic Data Interchange (EDI) and revises the Claims Processing Manual for hospice claims. Hospices are encouraged to review this Change Request.
However, in the original Transmittal (3813), there was an error in the table of hospice discharge reason codes (page 23). The original document incorrectly uses the phrase: ‘Condition Code’ versus ‘Occurrence Code’.
On September 26, CMS released Transmittal 3866 rescinding Transmittal 3813 due to this error. Both Transmittals refer to Change Request (CR 10064). This new Transmittal (3866) corrects the error.
This is the correct information:
|
Discharge Reason |
Coding Required in Addition to Patient Status Code |
|
Beneficiary Moves Out of Service Area |
Condition Code 52 |
|
Beneficiary Transfers Hospices |
Patient Status Code 50 or 51; no other indicator |
|
Beneficiary No Longer Terminally Ill |
No other indicator |
|
Beneficiary Discharged for Cause |
Condition code H2 |
|
Beneficiary Revokes |
Occurrence code 42 |
Click on this link to view the Transmittal in its entirety.
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