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Home Health & Hospice Week

Industry Note:

Don't Forget "OTH PHYS" Field On Claims

Published on Wed Apr 27, 2011

Just because you can leave the "OTH PHYS" field on hospice notices of election blank doesn't mean you can do the same for hospice claims. Hospices can't access the National Provider Identifier (NPI) field for the "OTH PHYS" line on hospice NOEs, so hospices have been instructed to leave that field blank as a temporary workaround (see Eli's HCW, Vol. XX, No. 16, p. 125). However, on hospice claims (TOB 8X1/ 8X2/8X3/8X4), providers should include the NPI in that field, HH MAC NHIC tells hospices. "The certifying physician information will be captured on the claim(s) that are submitted for the patient," NHIC tells providers in an e-mail message. A system fix for the problem is scheduled for December, HHH MAC Palmetto GBA notes on its website. When the fix takes effect, hospices must start including the physician's NPI in the "OTH PHYS" field on NOEs again, the contractor says.
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