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Infusion Pump Billing Sparks Claims Denials
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If your hospice claims with infusion pump items are getting denied, you’re not alone. HHH Medicare Administrative Contractor CGS “has identified a claims processing issue affecting hospice claims that include revenue code 029X for infusion pump equipment,” it explains in a message to providers. “Claims are being sent to the Return to Provider (RTP) file with reason code W7061 indicating that the service can only be billed to the Durable Medical Equipment Regional Carrier (DMERC).”
The problem is that Change Request 8538 requires hospice agencies to report infusion pumps with revenue code 029X, the MAC acknowledges. “CGS is currently researching this issue and will provide additional information via email as soon as it becomes available,” it says.
The other MACs also experienced problems with claims that report infusion pumps, but have said their problems are resolved, the National Association for Home Care & Hospice reports.
Eli's Hospice Insider
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