Eli's Hospice Insider
Know The Ropes To Avoid Facility NPI-Related Denials
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Report a facility NPI for these 5 place of service codes.
If Reason Code 34952 errors are killing your hospice claims, you’re not alone. Medicare Administrative Contractor “CGS has identified reason code 34952 as one of the top Claim Submission Error (CSE) errors,” it says on its website. “The reason code 34952 indicates that a service facility National Provider Identifier (NPI) is required on the claim, but was not reported.”
Do this: For dates of service on or after April 1, 2014, report a service facility NPI when billing any of the following place of service HCPCS codes: Q5003 — hospice care provided in nursing long term care facility (LTC) or non-skilled nursing facility (NF); Q5004 — hospice care provided in skilled nursing facility (SNF); Q5005 — hospice care provided in inpatient hospital; Q5007 — hospice care provided in long term care hospital (LTCH); and Q5008 — hospice care provided in inpatient psychiatric facility, CGS instructs.
“The service facility NPI must be reported in Loop 2310E (when billing in the 5010 electronic claim format) or the SERV FAC NPI field in the Fiscal Intermediary Standard System (FISS) on Claim Page 03,” CGS explains.
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