Eli's Hospice Insider

Published on Tue Nov 15, 2011 PDF

Hospices are nearly the last to use these types of claims.

Get ready to make a hospice billing change this spring. For April 1 or later services, hospices no longer will be able to submit late charge claims, the Centers for Medicare & Medicaid Services says in a new MLN Matters article.

Old way: Currently, hospices can submit late charges for professional services on a type of bill 815 or 825, CMS explains in MLN Matters article #MM7556. "These professional services could be processed as a late charge because they are paid a separate fee amount outside the hospice per diem payment amount," the agency notes.

Remember, late charge hospice claims are used for physician or nurse practitioner charges only, HHH Medicare Administrative Contractor CGS points out in a "Hospice Medicare Billing Codes Sheet" at www.cgsmedicare.com/hhh/education/pdf/Hospice_Medicare_Billing_Codes.pdf.

New way: Starting in April, hospices must make an adjustment to the original claim for the time period in which the services were provided. "To report such charges, hospices must submit an adjustment (or replacement) claim on bill type 817 or 827, placing all services for a billing period on one claim," CMS instructs.