Eli's Hospice Insider

Published on Mon Dec 15, 2014 PDF

For a reminder on how you can qualify for an exception to the five-day Notice of Election billing deadline, see a recent Medicare transmittal on the topic.

“In certain exceptional circumstances, a hospice can request the Medicare contractor to waive the consequences of filing the NOE late,” the Centers for Medicare & Medicaid Services explains in Nov. 6 CR 8923. “The hospice files the associated claim with occurrence span code 77 used to identify the non-covered, provider liable days. The hospice also reports a KX modifier with the Q HCPCS code reported on the earliest dated level of care line on the claim. The KX modifier prompts the Medicare contractor to request the documentation supporting the request for an exception. Based on that documentation, the Medicare contractor shall determine if a circumstance encountered by a hospice qualifies for an exception. If the request for an exception is approved by the Medicare contractor, the Medicare contractor processes the claim with a CWF override code and removes the submitted provider liable days, which will allow payment for the days associated with the late-filed NOE. If the Medicare contractor finds that the documentation does not support allowing an exceptional circumstance, the Medicare contractor shall process the claim as submitted.”